Performance comparison between three intraoral image receptors of different technology at a variety of tube potential, tube current and exposure time settings using a stepwedge phantom

Elli Katsoni, Ioannis A. Tsalafoutas, Panagiotis Gritzalis, Evripidis Stefanou, Evangelos Georgiou, Emmanuel Yakoumakis

Department of Medical Physics, Medical School, University of Athens, Athens, Greece.
Department of Oral Diagnosis and Radiology, Dental School, University of Athens, Athens, Greece.
Medical Physics Department, Agios Savvas Hospital, Athens, Greece.

DOI: 10.4236/health.2011.31011                

Abstract

Purpose: To comparatively evaluate the per-formance of three intraoral image receptors of different technology when exposed to different X-ray beam spectra, dose and dose rate levels using a stepwedge phantom. Materials and methods: The intraoral radiographic receptors evaluated were: the Kodak Insight F speed class film, the Kodak RVG 6000, and the Duerr Vis-tascan Combi PSP system. A dental quality control phantom made of Plexiglas, containing an aluminium stepwedge with 12 steps and 7 holes drilled in each step was radiographed using a dental X-ray unit offering a wide range of tube potential, tube current and exposure time settings. The visibility of the holes in the images produced with each one of the three receptors was assessed by three independent observers. For each image the total image quality score (TS) was derived from the summation of the number of visible holes in each step. The numbers of perceptible holes in each experimental condition (TSs) were statistically analyzed through use of analysis of variance. Intraobserver and interobserver agree-ment was also measured. Results: Vistascan ex-hibited the most extended useful exposure range, followed by RVG 6000 and Insight. RVG 6000 exhibited the largest TS values in all tube potential settings except 70 kV where the Vistascan performed better. Insight performed better than Vistascan only at 60 and 63 kV. Vistascan performed better at 66 and 70 kV, Insight at 60 and 66 kV, whereas RVG performed equally well at all tube potential settings, except than at 52 and 70 kV. For the Insight the largest TS values were obtained with the smallest ESAK values whereas with the Vistascan the largest TS were obtained with ESAK values that where the largest observed. Conclusions: The performance of all receptors tested was greatly dependent on the exposure parameters and mainly on the kV settings. Overall, the RVG 6000 offered the best image quality at doses somewhere in between those required by the Insight and the Vistascan.

Keywords

Radiography; Dental; Digital; Dosage

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	United Nations Scientific Committee on the Effects of Atomic Radiation (2000) Sources and effect of ionizing radiation. UNSCEAR publications, Report, 1.
[2]	European Union. Council Directive 97/43 Euratom (1997) On health protection of individuals against the dangers of ionizing radiation in relation to medical exposures, and repealing directive 84/466 Euratom. Official Journal of the European Communities, L180, 22.
[3]	Kitagawa, H. and Farman, A.G. (2004) Effect of beam energy and filtration on the signal-to-noise ratio of the Dexis intraoral X-ray detector. Dentomaxillofacial Radiology, 33, 21-24. doi:10.1259/dmfr/26493631
[4]	Wenzel, A. (2006) A review of dentists' use of digital radiography and caries diagnosis with digital systems. Dentomaxillofacial Radiology, 5, 307-314. doi:10.1259/dmfr/64693712
[5]	Hellen-Halme, K. (2007) Quality aspects of digital radiography in general dental practice. Swedish Dental Journal. Supplement, 184, 9-60.
[6]	Hellen-Halme, K., Nilsson, M. and Petersson, A. (2007) Digital radiography in general dental practice: A field study. Dentomaxillofacial Radiology, 36, 249-255. doi:10.1259/dmfr/95125494
[7]	Cowen, A.R., Kengyelics, S.M. and Davies, A.G. (2008) Solid-state, flat-panel, digital radiography detectors and their physical imaging characteristics. Clinical Radiology, 63, 487-498. doi:10.1016/j.crad.2007.10.014
[8]	Hintze, H. (2006) Diagnostic accuracy of two software modalities for detection of caries lesions in digital radiographs from four dental systems. Dentomaxillofacial Radiology, 35, 78-82. doi:10.1259/dmfr/50356588
[9]	Lanca, L., Silva, A., Alves, E., Serranheira, F. and Correia, M. (2008) Evaluation of exposure parameters in plain radiography: A comparative study with European guidelines. Radiation Protection Dosimetry, 129, 316-320. doi:10.1093/rpd/ncn144
[10]	Harada, T., Nishikawa, K., Shibuya, H., Hayakawa, Y. and Kuroyanagi, K. (1995) Sens-A-Ray characteristics with variation in beam quality. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics, 80, 120-123. doi:10.1016/S1079-2104(95)80028-X
[11]	Goshima, T., Goshima, Y., Scarfe, W.C. and Farman, A.G. (1996) Sensitometric response of the Sens-A-Ray, a charge coupled imaging device, to changes in beam energy. Dentomaxillofacial Radiology, 25, 17-18.
[12]	McDonnell, D. and Price, C. (1993) An evaluation of the Sens-A-Ray digital dental imaging system. Dentomaxillofacial Radiology, 22, 121-126.
[13]	Kitagawa, H. and Farman, A.G. (2004) Effect of beam energy and filtration on the signal to noise ratio of the Dexis intraoral x-ray detector. Dentomaxillofacial Radiology, 33, 21-24. doi:10.1259/dmfr/26493631
[14]	Yoshiura, K., Kawazu, T., Chikui, T., Tatsumi, M., Tokumori, K., Tanaka, T., et al. (1999) Assessment of image quality in dental radiography, part 1: Phantom validity. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 87, 115-122. doi:10.1016/S1079-2104(99)70304-5
[15]	Yoshiura, K., Kawazu, T., Chikui, T., Tatsumi, M., Tokumori, K., Tanaka, T., et al. (1999) Assessment of image quality in dental radiography, part 2: Optimum exposure conditions for detection of small mass changes in 6 intraoral radiography systems. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 87, 123-129. doi:10.1016/S1079-2104(99)70305-7
[16]	Ang, D.B., Angelopoulos, C. and Katz, J.O. (2006) How does signal fade on photo-stimulable storage phosphor imaging plates when scanned with a delay and what is the effect on image quality? Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 102, 673-679. doi:10.1016/j.tripleo.2005.11.002
[17]	Ramamurthy, R., Canning, C.F., Scheetz, J.P. and Farman, A.G. (2004) Impact of ambient lighting intensity and duration on the signal-to-noise ratio of images from photostimulable phosphor plates processed using DenOptix and ScanX systems. Dentomaxillofacial Radiology, 33, 307-311. doi:10.1259/dmfr/91373164
[18]	Parsons, D.M., Kim, Y. and Haynor, D.R. (1995) Quality control of cathode-ray tube monitors for medical imaging using a simple photometer. Journal of Digital Imaging, 8, 10-20. doi:10.1007/BF03168051
[19]	Jervis, S.E. and Brettle, D.S. (2003) A practical approach to soft-copy display consistency for PC-based review workstations. The British Journal of Radiology, 76, 648-652. doi:10.1259/bjr/25693100
[20]	Alpoz, E., Sogur, E. and Baksi Akdeniz, B.G. (2007) Perceptibility curve test for digital radiographs before and after application of various image processing algorithms. Dentomaxillofacial Radiology, 36, 490-494. doi:10.1259/dmfr/20897311
[21]	Li, G., Sanderink, G.C., Berkhout, W.E., Syriopoulos, K. and van der Stelt, P.F. (2007) Detection of proximal caries in vitro using standard and task-specific enhanced images from a storage phosphor plate system. Caries Research, 41, 231-234. doi:10.1159/000099324
[22]	Koob, A., Sanden, E., Hassfeld, S., Staehle, H.J. and Eickholz, P. (2004) Effect of digital filtering on the measurement of the depth of proximal caries under different exposure conditions. American Journal of Dentistry, 17, 388-393.
[23]	Li, G., Engstr?m, P.E. and Welander, U. (2007) Measurement accuracy of marginal bone level in digital radiographs with and without color coding. Acta Odontologica Scandinavica, 65, 254-258. doi:10.1080/00016350701452089
[24]	Berkhout, W.E., Beuger, D.A., Sanderink, G.C. and van der Stelt, P.F. (2004) The exposure range of digital radiographic systems: Dose reduction or risk of overexposure? Dentomaxillofacial Radiology, 33, 1-5. doi:10.1259/dmfr/40677472
[25]	Borg, E., and Grondahl, H.G. (1996) On the exposure range of different X-ray photon detectors in intra-oral radiography. A comparison of image quality in film, charge-coupled device and storage phosphor systems. Dentomaxillofacial Radiology, 25, 82-88.
[26]	Borg, E., Attaelmanan, A. and Grondahl, H.G. (2000) Image plate systems differ in physical performance. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 89, 118-124. doi:10.1016/S1079-2104(00)80026-8
[27]	Farman, A.G. and Farman, T.T. (2005) A comparison of 18 different x-ray detectors currently used in dentistry. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 99, 485-489. doi:10.1016/j.tripleo.2004.04.002
[28]	Kitagawa, H., Farman, A.G., Scheetz, J.P., Brown, W.P., Lewis, J., Benefiel, M., et al. (2000) Comparison of three intra-oral storage phosphor systems using subjective image quality. Dentomaxillofacial Radiology, 29, 272-276.
[29]	doi:10.1038/sj.dmfr.4600532 Willis, C.E. (2004) Strategies for dose reduction in ordinary radiographic examinations using CR and DR. Pediatric Radiology, 34, 196-200. doi:10.1007/s00247-004-1269-6
[30]	Svenson, B., Grondahl, H.G., Petersson, A. and Olving, A. (1985) Accuracy of radiographic caries diagnosis at different kilovoltages and two film speeds. Swedish Dental Journal, 9, 37-43.
[31]	Kaeppler, G., Dietz, K. and Reinert, S. (2007) Influence of tube potential setting and dose on the visibility of lesions in intraoral radiography. Dentomaxillofacial Radiology, 36, 75-79. doi:10.1259/dmfr/75743437
[32]	Ramamurthy, R., Scheetz, J.P., Clark, S.J. and Farman, A.G. (2006) Effects of imaging system and exposure on accurate detection of the second mesio-buccal canal in maxillary molar teeth. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 102, 796-802. doi:10.1016/j.tripleo.2006.02.009
[33]	Radiation Protection (2004) European guidelines on radiation protection in dental radiology. The safe use of radiographs in dental practice. Issue No. 136.
[34]	Yakoumakis, E.N., Tierris, C.E., Stefanou, E.P., Pha- nourakis, I.G. and Proukakis, C.C. (2001) Image quality assessment and radiation doses in intraoral radiography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 91, 362-368. doi:10.1067/moe.2001.111940
[35]	Hatziioannou, K., Psarouli, E., Papanastassiou, E., Bous- bouras, P., Kodona, H., Kimoundri, O., et al. (2005) Quality control and diagnostic reference levels in intraoral dental radiographic facilities. Dentomaxillofacial Radiology, 34, 304-307. doi:10.1259/dmfr/38802780
[36]	Gonzalez, L. and Moro, J. (2007) Patient radiation dose management in dental facilities according to the X-ray focal distance and the image receptor type. Dentomaxillofacial Radiology, 36, 282-284.
[37]	Valentin, J. (2007) The 2007 recommendations of the international commission on radiological protection. Elsevier, Oxford. doi:10.1259/dmfr/67494525
[38]	Ludlow, J.B., Davies-Ludlow, L.E. and White, S.C. (2008) Patient risk related to common dental radiographic examinations: The impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation. Journal of American Dental Association, 139, 1237-1243.