Fact or fiction: An analysis of the 10 kVp ‘rule’ in computed radiography

Allen, Elizabeth; Hogg, Peter; Kei, Wang; Szczepura, Katy

doi:10.1016/j.radi.2013.05.003

Cited by 22 publications

(29 citation statements)

References 4 publications

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“…A literature review was conducted in order to identify the determinants of image quality perception of a PA chest radiograph (11,(16)(17)(18). Factors were developed into scale items suitable for creating the psychometric scale; this was guided by Bandura's theory of self-efficacy and the literature surrounding the construction of a psychometric scale [19,20].…”

Section: Literature Review and Scale Developmentmentioning

confidence: 99%

Increasing source to image distance for AP pelvis imaging – Impact on radiation dose and image quality

et al. 2014

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PURPOSE: To develop and validate a psychometric scale for assessing Image quality perception for chest radiographs.METHODS: A review of the literature was undertaken to identify items/factors which could be used to evaluate image quality using a perceptual approach. A draft scale was then created (22 items) and presented to a focus group (student, qualified radiographers and radiology registers). Within the focus group the draft scale was discussed and modified. A series of seven postero-anterior chest images were generated using a phantom with a range of image qualities. Image quality perception was initially confirmed for the seven images using signal-to-noise ratio (SNR) and group consensus. Participants were invited to independently score each of the images using the draft image quality perception scale. Bandura's theory was used to guide scale development and Cronbach alpha was used to test interval reliability.RESULTS: Fifty three participants used the scale to grade image quality perception on each of the seven images (SNR 17.2 to 36.5). Aggregated mean scale score increased with increasing SNR from 42.1 to 87.7 (r=0.98, P<0.001). For each of the 22 individual scale items there was clear differentiation of low, mid and high-quality images. A Cronbach alpha coefficient of >0.7 was obtained across each of the seven images.CONCLUSION: This study represents the first development of a chest image quality perception scale based on Bandura's theory. There was excellent correlation between the image quality perception scores derived using the scale and the SNR and group consensus. Further research will involve a more detailed item and factor analysis.

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Section: Literature Review and Scale Developmentmentioning

confidence: 99%

Increasing source to image distance for AP pelvis imaging – Impact on radiation dose and image quality

et al. 2014

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“…Many previous studies have investigated the use of this particular dose optimization strategy by examining qualified observers' perceptions of resultant image quality using a variety of different methods [7][8][9][10][11]. However, more robust and comprehensive work is still needed, particularly in terms of the number and type of participants providing assessments of perceived image quality and the number of anatomic areas examined in a single study.…”

Section: Introductionmentioning

confidence: 99%

“…This, of course, lessens the external validity, or the generalizability, of the results. With respect to the number of anatomic areas examined, many of the similar existent studies reviewed have only used one anatomic area [4,7,[9][10][11]. This limited focus is problematic because different anatomic areas vary in thickness and require that images be acquired with differing technical factors that in turn affect image quality and dose delivered to the patient.…”

Section: Introductionmentioning

confidence: 99%

Examining Practitioners' Assessments of Perceived Aesthetic and Diagnostic Quality of High kVp–Low mAs Pelvis, Chest, Skull, and Hand Phantom Radiographs

Lorusso

Fitzgeorge

Lorusso

et al. 2015

Journal of Medical Imaging and Radiation Sciences

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This study investigated the usefulness of the dose optimization strategy of increased tube voltage (kVp) and decreased tube current-exposure time product (mAs) (or high kVp-low mAs) by examining practitioners' assessments of perceived aesthetic and diagnostic quality of direct digital radiographs acquired using this strategy. Ninety-one practitioners (radiologists, radiology residents, radiographers, and radiography students) from eight clinical sites in Ontario examined three types of radiographs (''standard'' image, þ20 kVp image, and þ30 kVp image) for anthropomorphic pelvis, chest, skull, and hand phantoms and rated (on a five-point scale) each image in regard to its perceived aesthetic quality, perceived diagnostic quality, and visualization of anatomic structures. Our primary findings are that for the pelvis, skull, and hand-although not the chest-images acquired using standard technical factors were rated significantly higher in diagnostic and aesthetic quality than those acquired using the high kVp-low mAs strategy. Despite this, both standard and dose-optimized images of the pelvis, skull, and hand were rated to be of acceptable diagnostic quality for clinical use. In conclusion, for the pelvis, skull, and hand, an increase of 20 kVp was an effective strategy to reduce dose while still acquiring images of diagnostic quality. RESUM E Cette etude evalue l'utilit e de la strat egie d'optimisation de la dose fond ee sur l'augmentation de la tension du tube (kVp) et de la diminution du produit tube de courant/temps d'exposition (mAs) (ou kVp elev e-mAs faible) en examinant l' evaluation que font les praticiens de la qualit e esth etique et diagnostique perçue des radiographies num eriques directes prises a l'aide de cette strat egie. Quatre-vingt onze praticiens (radiologistes, r esidents en radiologie, radiographes et etudiants en radiographie) de huit sites cliniques en Ontario ont examin e trois types de radiographies (image « standard », image a þ20 kVp, image a þ30 kVp) de fantômes anthropomorphiques du pelvis, de la poitrine, du crâne et de la main et les ont cot ees (sur une echelle de 1 a 5) selon (a) qualit e esth etique perçue, (b) leur qualit e diagnostique perçue et (c) la visualisation des structures anatomiques. Nos constatations initiales montrent que, dans le cas des images du pelvis, du crâne et de la main, mais non celles de la poitrine, les images prises avec les facteurs techniques standard ont reçu une note significativement plus elev ee pour la qualit e esth etique et diagnostique que celles prises en utilisant la technique kVp elev e-mAs faible. Cependant, les images standard et a dose optimis ee du pelvis, du crâne et de la main ont et e jug ees de qualit e diagnostique acceptable pour un usage clinique. En conclusion, pour le pelvis, le crâne et la main, une augmentation de þ20 kVp est une strat egie efficace pour r eduire la dose tout en produisant quand même des images de qualit e diagnostique.

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“…This was done to ensure in it would have an intermediate level (median) of sharpness and noise. Selecting the reference image in this way was undertaken in order to allow the observer to use the whole of the Likert scale during relative VGA and thus reduce skewness during scoring [28]. A similar approach for choosing reference images was used by Mraity (2015) [29] and supported by Lance et al (2014) [30].…”

Section: Image Quality and Radiation Dose Assessmentmentioning

confidence: 99%

Dose optimisation in paediatric radiography – Using regression models to investigate the relative impact of acquisition factors on image quality and radiation dose

2019

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Objective: To investigate the optimum pelvis X-ray acquisition factors for a 10-year-old child. Secondly, to evaluate the impact of each acquisition factor on image quality (IQ) and radiation dose. Method: Images were acquired using a pelvis phantom and a range of acquisition parameters; e.g. tube potential, additional filtration and source-to-image distance (SID). Automatic exposure control (AEC) was used with two orientations (head towards/away from two outer chambers) and three different chamber selections. Visual IQ was evaluated using relative and absolute-VGA methods. Radiation doses were measured by placing a dosimeter on the anterior surface of the phantom. Regression analysis was used to determine optimum parameters. Results: The optimised technique (178.8 µGy), with diagnostic IQ, was with 89kVp, 130 cm SID and with 1 mm Al + 0.1 mm Cu filtration. This technique was with the head towards the two outer AEC chambers. Regression analysis showed that SID had the lowest impact on IQ (β = 0.002 95% CI −0.001 to 0.005) and dose (β = −0.96 95% CI −0.40 to −1.53). The impact of filtration on dose (β = −76.24 95% CI −86.76 to −85.72) was higher than tube potential (β = −13.44 95% CI −14.34 to −12.53). The following impact ratios were higher on IQ than radiation dose: filtration/kVp; 11.28 times, filtration/SID; 7.01 times and kVp/SID; 0.62 times. Conclusion: Optimised parameters were identified as 89 kVp, 130 cm SID and with 1 mm Al + 0.1 mm Cu additional filtration. Regression analysis demonstrated that filtration and tube potential had the greatest effect on radiation dose and IQ, respectively.

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Fact or fiction: An analysis of the 10 kVp ‘rule’ in computed radiography

Cited by 22 publications

References 4 publications

Increasing source to image distance for AP pelvis imaging – Impact on radiation dose and image quality

Increasing source to image distance for AP pelvis imaging – Impact on radiation dose and image quality

Examining Practitioners' Assessments of Perceived Aesthetic and Diagnostic Quality of High kVp–Low mAs Pelvis, Chest, Skull, and Hand Phantom Radiographs

Dose optimisation in paediatric radiography – Using regression models to investigate the relative impact of acquisition factors on image quality and radiation dose

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