Besti Cadwaladr University Health Board, Ysbyty Gwynedd, Pnerhosgarnedd Road, Bangor, Gwynedd, LL57 2PW, UK.
Bangor University, College Road, Bangor, LL57 2DG, UK.
Radiography (Lond). 2021 Feb;27(1):75-80. doi: 10.1016/j.radi.2020.06.005. Epub 2020 Jul 4.
Neonates are a particularly vulnerable patient group with complex medical needs requiring frequent radiographic examinations. This study aims to compare computed radiography (CR) and direct digital radiography (DDR) portable imaging systems used to acquire chest x-rays for neonates within incubators.
An anthropomorphic neonatal chest phantom was imaged under controlled conditions using one portable machine but captured using both CR and DDR technology. Other variables explored were: image receptor position (direct and incubator tray), tube current and kV. All other parameters were kept consistent. Contrast-to-noise ratio (CNR) was measured using ImageJ software and dose-area-product (DAP) was recorded. Optimisation score was calculated by dividing CNR with the DAP for each image acquisition.
The images with the highest CNR were those acquired using DDR direct exposures and the images with lowest CNR were those acquired using CR with the image receptor placed within the incubator tray. This is also supported by the optimisation scores which demonstrated DDR direct produced the optimal combination with regards to CNR and radiation dose. The CNR had a mean increase of 50.3% when comparing DDR direct with CR direct respectively. This was also evident when comparing DDR and CR for in-tray acquisitions, with CNR increasing by a mean of 43.5%. A mean increase of 20.4% was seen in CNR when comparing DDR tray exposures to CR direct.
DDR direct produced images of highest CNR, with incubator tray reducing CNR for both CR and DDR. However, DDR tray still had better image quality compared to CR direct.
Where possible, DDR should be the imaging system of choice for portable examinations on neonates owing to its superior image quality at lower radiation dose.
新生儿是一个特别脆弱的患者群体，他们有复杂的医疗需求，需要频繁进行放射检查。本研究旨在比较在保温箱内为新生儿拍摄胸部 X 光片时使用的计算机射线照相（CR）和直接数字射线照相（DDR）便携式成像系统。
在控制条件下，使用一台便携式机器对模拟新生儿胸部的人体模型进行成像，但使用 CR 和 DDR 技术进行捕获。还探索了其他变量：影像接收器位置（直接和保温箱托盘）、管电流和千伏。所有其他参数保持一致。使用 ImageJ 软件测量对比度噪声比（CNR），并记录剂量面积产品（DAP）。为每个图像采集计算优化得分，方法是将 CNR 除以每个图像采集的 DAP。
最高 CNR 的图像是使用 DDR 直接曝光获得的，而最低 CNR 的图像是使用 CR 将影像接收器放置在保温箱托盘内获得的。这也得到了优化得分的支持，该得分表明 DDR 直接在 CNR 和辐射剂量方面产生了最佳组合。与 CR 直接相比，当比较 DDR 直接时，CNR 的平均增加了 50.3%。当比较 DDR 和 CR 进行托盘内采集时，CNR 也增加了平均 43.5%。当比较 DDR 托盘曝光与 CR 直接时，CNR 平均增加了 20.4%。
DDR 直接产生的图像具有最高的 CNR，而保温箱托盘会降低 CR 和 DDR 的 CNR。然而，与 CR 直接相比，DDR 托盘仍然具有更好的图像质量。
在可能的情况下，由于 DDR 具有更低的辐射剂量和更高的图像质量，应将其作为新生儿便携式检查的首选成像系统。
