City Research Online

Effects of body part thickness on low‐contrast detail detection and radiation dose during adult chest radiography

Al‐Murshedi, S., Alzyoud, K., Benhalim, M. , Alresheedi, N., Papathanasiou, S. ORCID: 0000-0002-1081-8530 & England, A. (2023). Effects of body part thickness on low‐contrast detail detection and radiation dose during adult chest radiography. Journal of Medical Radiation Sciences, 71(1), pp. 85-90. doi: 10.1002/jmrs.741


Differences in patient size often provide challenges for radiographers, particularly when choosing the optimum acquisition parameters to obtain radiographs with acceptable image quality (IQ) for diagnosis. This study aimed to assess the effect of body part thickness on IQ in terms of low‐contrast detail (LCD) detection and radiation dose when undertaking adult chest radiography (CXR).

This investigation made use of a contrast detail (CD) phantom. Polymethyl methacrylate (PMMA) was utilised to approximate varied body part thicknesses (9, 11, 15 and 17 cm) simulating underweight, standard, overweight and obese patients, respectively. Different tube potentials were tested against a fixed 180 cm source to image distance (SID) and automatic exposure control (AEC). IQ was analysed using bespoke software thus providing an image quality figure inverse (IQFinv) value which represents LCD detectability. Dose area product (DAP) was utilised to represent the radiation dose.

IQFinv values decreased statistically (P = 0.0001) with increasing phantom size across all tube potentials studied. The highest IQFinv values were obtained at 80 kVp for all phantom thicknesses (2.29, 2.02, 1.8 and 1.65, respectively). Radiation dose increased statistically (P = 0.0001) again with increasing phantom thicknesses.

Our findings demonstrate that lower tube potentials provide the highest IQFinv scores for various body part thicknesses. This is not consistent with professional practice because radiographers frequently raise the tube potential with increased part thickness. Higher tube potentials did result in radiation dose reductions. Establishing a balance between dose and IQ, which must be acceptable for diagnosis, can prevent the patient from receiving unnecessary additional radiation dose.

Publication Type: Article
Additional Information: © 2023 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Publisher Keywords: CDRAD 2.0 phantom, chest radiography, image quality, low-contrast details detectability, obesity, radiation dose
Subjects: R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Midwifery & Radiography
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