Performance of automatic exposure control on dose and image quality: comparison between slot‐scanning and flat‐panel digital radiography systems

Abstract

Background EOSedge™* (EOS Imaging, Paris, France) is an X‐ray imaging system using automatic exposure control (AEC) with tube current modulation, in order to optimize dose deposition in patients. Purpose This study aims at characterizing EOSedge organ dose deposition in comparison to a digital radiography (DR) system and the previous EOS system (EOS‐1st generation), in relation to their respective image quality levels. Method Organ doses were measured in an anthropomorphic female adult phantom and a 5‐year‐old pediatric phantom using optically stimulated luminescence (OSL) dosimeters, which were carefully calibrated within the studied energy range. Organ doses were recorded on the EOSedge and the Fuji Visionary DRF (Fujifilm Medical Systems U.S.A., Inc, Lexington, MA). The resulting effective doses were compared to the EOS‐1st‐generation values present in the literature. Image quality assessment was carried out on end‐user images. Quantitative image quality metrics were computed for all tested modalities on a quality assurance phantom. Qualitative assessment of EOSedge image quality was based on anthropomorphic phantom acquisitions against the EOS‐1st‐generation system, and on clinical images against the tested DR system. Results For a full‐spine exam, and on the female adult phantom (respectively, the pediatric phantom), an effective dose of 92 μSv (respectively, 32 μSv) was obtained on EOSedge, and 572 μSv (respectively, 179 μSv) on the DR system; these values were compared to effective dose values of 290 μSv (respectively, 200 μSv) from the literature on EOS‐1st generation, leading to an effective dose reduction factor of 6 with respect to the DR system, and of 3–6 with respect to EOS‐1st generation. EOSedge provides the best compromise between contrast‐to‐noise ratio (CNR) and dose, with more consistent CNR values than the other tested modalities, in a range of attenuation from 10 to 40 cm of poly(methyl methacrylate) (PMMA). Within this range, EOSedge is also comparable to DR for 10 and 20 cm of PMMA, and better than DR for 30 and 40 cm of PMMA, both in terms of spatial resolution and low‐contrast detection. The anatomical landmarks of interest in the follow‐up of spinal deformities can be detected in all tested modalities. Conclusion Results showed that EOSedge provides significant dose reduction factors for full spine imaging in both adults and children compared to the other tested modalities, without compromising image quality. We believe that this work could help raise awareness on the capabilities of modern X‐ray systems, when equipped with appropriate AEC strategies, to perform ultra‐low‐dose, long‐axis images.

Health technology assessment in musculoskeletal radiology: the case study of EOSedge™

“…Recent research assessed the EOSedge organ radiation dose administration compared to the 1st generation-EOS system focusing on their respective image quality levels [ 26 ]. Organ doses were evaluated in an anthropomorphic female adult phantom and a 5-year-old pediatric male phantom using optically stimulated luminescence dosimeters, calibrated in advance within the range of studied energy.…”

“…Organ doses were evaluated in an anthropomorphic female adult phantom and a 5-year-old pediatric male phantom using optically stimulated luminescence dosimeters, calibrated in advance within the range of studied energy. Organ doses were recorded on the EOSedge and the Fuji Visionary DRF (Fujifilm Medical Systems U.S.A., Inc., Lexington, MA) [ 26 ]. The effective doses resulting from the experiment were compared to the EOS 1st-generation doses reported in literature.…”

“…The anatomical landmarks which were considered in the follow-up of spinal deformities could be detected in all assessed modalities. Data showed that EOSedge provides significant dose reduction factors for full spine imaging in both adults and children as compared to the EOS System without deterioration of image quality [ 26 ].…”

“…Table 1 shows the main features of EOSedge and EOS System taken from the literature analysis [ 26 ] and user manuals [ 8 ], which allow for a comparison between the two technologies (Table 1 ).…”

Evaluation of the cardiopulmonary size on slot-scanning full-spine radiographs

“…During projection radiography, the imaged body part is irradiated all at once. In contrast, during slot-scanning acquisition a slit beam fans through the imaged region, resulting in improved rejection of scattered beams, better signal to noise ratio, and a reduction of radiation burden [1][2][3]. The EOS technique is mostly used for scoliosis diagnostics and other bone and vertebral pathologies.…”