Comparison of Non-Uniform Image Quality Caused by Anode Heel Effect between Two Digital Radiographic Systems Using a Circular Step-Wedge Phantom and Mutual Information.

The purpose of this study was to compare non-uniform image quality caused by the anode heel effect between two radiographic systems using a circular step-wedge (CSW) phantom and the normalized mutual information (nMI) metric. Ten repeated radiographic images of the CSW and contrast-detail resolution (CDR) phantoms were acquired from two digital radiographic systems with 16- and 12-degree anode angles, respectively, using various kVp and mAs. To compare non-uniform image quality, the CDR phantom was physically rotated at different orientations, and the directional nMI metrics were calculated from the CSW images. The directional visible ratio (VR) metrics were calculated from the CDR images. Analysis of variance (ANOVA) was performed to understand whether the nMI metric significantly changed with kVp, mAs, and orientations with Bonferroni correction. Mann-Whitney's U test was performed to compare the metrics between the two systems. Contrary to the VR metrics, the nMI metrics significantly changed with orientations in both radiographic systems. In addition, the system with the 12-degree anode angle exhibited less uniform image quality compared to the system with the 16-degree anode angle. A CSW phantom using the directional nMI metric can be significantly helpful to compare non-uniform image quality between two digital radiographic systems.