RSNA Session Recap: Improve Image Quality While Decreasing Dose

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Jackie Whaley, Carestream

Three studies by Carestream R&D presented at RSNA this week featured some of  our latest work to reduce patient dose exposure:

First, “Maximizing Lesion Conspicuity in Chest Radiography: Application of Low-Energy X-rays with Rib-contrast Suppression” was presented on Monday.

The study evaluated the use of low-kVp imaging in combination with rib-contrast suppression (RCS) to improve and maximize the appearance of lesions in chest x-rays at the same patient dose. A cesium iodide Carestream DRX detector was used in the study, which concluded that anatomy contrast and lesion visualization can be maximized when lower kVp is used in combination with rib-contrast suppression. Low kVp with RCS can be used to maximize the diagnostic quality of chest X-rays while maintaining the same patient dose, or to reduce the patient dose while maintaining the same diagnostic quality.

Second, “Task-Specific Dose Reduction for Neonatal Chest Imaging Using a CsI Direct Radiographic (DR) Detector” was presented on Tuesday.  The study was designed to determine the dose reduction potential in neonatal ICU imaging using a Carestream cesium iodide DRX detector. Pediatric radiologists independently marked the location of three features in each image: carina, endotracheal tube tip (ETT), and largest pneumatocele. The study concluded that while currently neonatal patients receive an effective dose of 15-20 µSv for chest exams, employment of task-specific techniques such as a low-dose ETT study and a higher-dose lung parenchymal study could promote dose reduction without affecting diagnosis. These findings are important because of the challenges of acquiring diagnostic quality radiographs of neonatal patients at the lowest possible dose.

Also on Tuesday, “Neonatal and Pediatric, Portable, Digital-Radiographic AP Chest Imaging: Weight-specific kVp Selection to Optimize Effective Dose and Image Quality” was presented. Pediatric patients are particularly sensitive to X-ray dose. This study evaluated the ability for physicians to detect small lung nodules imaged with a wireless Carestream DRX cesium iodide detector. The goal was to evaluate overall imaging performance to identify the best kVp as a function of weight. Typically, neonatal patients of less than 3 kg are imaged at or above 60 kVp. This study presents evidence that they should be imaged a lower kVp to optimize imaging quality and effective dose.

To learn more about the Carestream cesium iodide detector and how your facility can decrease dose for your patients, visit us at RSNA 2012 in South Hall, or visit


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