A review of image quality and dose issues in digital fluorography and digital subtraction angiography

This paper addresses image quality and dose issues in Digital Fluorography (DF) and Digital Subtraction Angiography (DSA). commencing with a brief review of methods and protocols for image quality assessment in DF and DSA. The relative scarcity of standards and test protocols for unsubtracted DF is highlighted. Pooled results from a large number of quality assurance rests are then used to illustrate trends in the choice of radiation dose per image currently employed in typical DF and DSA work. It is concluded that, although relatively high doses per image may be justified in terms of image quality improvement for DSA, there is little justification for the large range of exposures used in DF for nominally identical examinations. It is argued that the use of high doses per image in DF would not be expected to offer an advantage in terms of image signal-to-noise ratio.