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Purpose: The conditions under which vendor performance criteria for digital radiography systems are obtained do not adequately simulate the conditions of actual clinical imaging with respect to radiographic technique factors, scatter production, and scatter control. Therefore, the relationship between performance under ideal conditions and performance in clinical practice remains unclear. Using data from a large complement of systems in clinical use, the authors sought to develop a method to establish expected performance criteria for digital flat-panel radiography systems with respect to signal-to-noise ratio (SNR) versus detector exposure under clinical conditions for thoracic imaging. Methods: The authors made radiographic exposures of a patient-equivalent chest phantom at 125 kVp and 180 cm source-to-image distance. The mAs value was modified to produce exposures above and below the mAs delivered by automatic exposure control. Exposures measured free-in-air were corrected to the imaging plane by the inverse square law, by the attenuation factor of the phantom, and by the Bucky factor of the grid for the phantom, geometry, and kilovolt peak. SNR was evaluated as the ratio of the mean to the standard deviation (SD) of a region of interest automatically selected in the center of each unprocessed image. Data were acquired from 18 systems, 14 of which were tested both before and after gain and offset calibration. SNR as a function of detector exposure was interpolated using a double logarithmic function to stratify the data into groups of 0.2, 0.5, 1.0, 2.0, and 5.0 mR exposure (1.8, 4.5, 9.0, 18, and 45 μGy air KERMA) to the detector. Results: The mean SNR at each exposure interval after calibration exhibited linear dependence on the mean SNR before calibration (r2 = 0.9999). The dependence was greater than unity (m = 1.101 ± 0.006), and the difference from unity was statistically significant (p |
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