Comparing image quality of flat-panel chest radiography with storage phosphor radiography and film-screen radiography

OBJECTIVE: To evaluate image quality of a large-area direct-readout flat-panel detector system in chest radiography, we conducted an observer preference study. A clinical comparative study was conducted of the flat-panel system versus the storage phosphor and standard film-screen systems. MATERIALS AND METHODS: Routine chest radiographs (posteroanterior) of 30 patients that were obtained using flat-panel, storage phosphor, and film screen systems were compared. The visibility of 10 anatomic regions and the overall image quality criteria were rated independently by three radiologists using a 5-point scale. The significance of the differences in diagnostic performance was tested with a Wilcoxon's signed rank test. Dose measurements for the three modalities were performed. RESULTS: The flat-panel radiography system showed an improved visibility in most anatomic structures when compared with a state-of-the-art conventional film-screen system and an equal visibility when compared with a storage phosphor system. The flat-panel system showed the greatest enhancement in the depiction of small detailed structures (p < 0.05) and achieved this with a reduction in overall radiation dose of more than 50%. CONCLUSION: The visibility of anatomic structures provided by this flat-panel detector system is as good as if not better than that provided by conventional or storage phosphor systems while emitting a reduced radiation dose.