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[Variation in X-ray dose quantity using an amorphous selenium based flat-panel detector -- a study on the dose reduction rate up to the limit of diagnostical utilization].

PURPOSE
To evaluate the diagnostic quality and minimum required dose to obtain acceptable images for diagnostic purposes in the field of musculoskeletal radiology.


MATERIALS AND METHODS
A critical comparison of the image quality produced by a novel flat panel detector and the conventional screen/film system using a contrast-detail phantom was performed in phase I. Images from both systems were obtained with the same dose and displayed with similar contrast and density. In phase II images of significant anatomical structures in cadaver extremities obtained using the digital detector system and the standard film/screen system were critically evaluated. After a successive reduction in the X-ray dose for 84 patients in phase III, eight independent radiologists compared the image quality of the screen/film system to that of the novel flat panel detector.


RESULTS
Phases I and II revealed a difference in the image quality achieved by the standard screen/film system and the digital detector system to the advantage of the digital detector system. In 77 of 84 patients (91.7 %), phase III showed equal image quality after a 50 % reduction in the X-ray dose. In 3 cases (3.6 %) the image quality and the level of contrast were better. No unified statement could be made for 4 patients (4.7 %).


CONCLUSION
Digital imaging of skeletal disorders using the novel flat panel detector makes it possible to reduce the X-ray dose by 50 % with equal or even better image quality.