The optimisation of lumbar spine AP radiography using a realistic computer model

A Monte Carlo computer program has been developed to model X ray imaging systems realistically using an adult voxel phantom. Image quality is quantified in terms of contrast and signal-to-noise ratio (SNR) for six important anatomical details chosen in accordance with recent European guidelines. The program has been used to study and optimise lumbar spine (LS) radiographic systems. As an example, the effect of tube potential on contrast, SNR and effective dose for the LS AP examination is demonstrated. Optimisation involves comparison of performance with that of a reference system. Configurations (tube potential, grid and screen-him) have been found which approximately match the reference image quality, but at lower effective dose. Various configurations give good performance. Some result in significant dose reduction. For LS AP 400 and 600 speed-class systems, dose savings of 21% and 34% are achievable. The model is thus a powerful tool for system optimisation.