The effect of radiation dose reduction on clinical image quality in chest radiography of premature neonates using a dual-side readout technique computed radiography system

The purpose of the present study was to investigate if the exposure could be reduced from the clinical setting (resulting in an effective dose of 8 mu Sv for a neonate of weight 0.7 kg and height 25 cm at a tube voltage of 90 kV) without negatively influencing the image quality for a dual-side readout technique computed radiography (CR) system in chest radiography of premature neonates. Chest radiographs of premature neonates were acquired with the double-side readout technique CR system. The images underwent simulated dose reduction in steps of 20 % to represent five different radiation dose levels. Four image quality criteria, related to the visibility of important anatomical structures, were used in a visual grading study where five experienced radiologists rated how well the criteria were fulfilled for all images. When reducing the radiation dose, a decrease in image quality could be observed already at the 80 % dose level for all the structures. The results indicate that a decrease in exposure from the clinically used setting affects the image quality negatively for the CR system.