Digital amorphous silicon flat-panel detector radiography at different exposure doses versus mammography film: possibility of radiation dose reduction in detecting rheumatologic bone defects

Abstract

Background: Radiographic examinations of the skeleton are the most commonly performed radiologic procedures, even outnumbering examinations of the chest. The imaging systems used in skeletal radiography must meet high standards in terms of contrast and spatial resolution to effectively visualize the high contrast between bone and soft tissue as well as fine bone structures. Purpose: To determine the performance of amorphous silicon flat-panel detector radiography compared to mammography film in detecting rheumatologic bone defects at different exposure doses. Material and Methods: The study enrolled 44 patients with known or presumed skeletal changes of the hand associated with inflammatory rheumatic diseases. Following a clinically indicated radiographic examination of the peripheral extremities using mammography film, a survey radiograph of one hand was taken in the posteroanterior (PA) view by digital radiography, at the same exposure dose and at a dose reduced to one quarter of the mammography film doses. Four independent radiologists scored the resultant images using the Sharp/van der Heijde and Ratingen scoring methods. The study received University of Cologne Ethics Committee and German Federal Radiation Protection Agency approval. Results: Compared to mammography film, digital flat-panel detector radiography produced a significantly better image quality at identical uptake doses. A greater number of erosions were detected with the digital flat-panel detector than with mammography film at the same and at reduced doses. Conclusion: Although the spatial resolution of the digital flat-panel system used in this study was poorer than mammography film, this was compensated for by its wider dynamic range and improved contrast resolution, even at the reduced dose.