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Flat-Panel X-Ray Detector Using Amorphous Silicon Technology: Reduced Radiation Dose for the Detection of Foreign Bodies

VÖLK, MARKUS MD*; STROTZER, MICHAEL MD*; GMEINWIESER, JOSEF MD*; ALEXANDER, JOACHIM; FRÜND, RÜDIGER PHD*; SEITZ, JOHANNES MD*; MANKE, CHRISTOPH MD*; SPAHN, MARTIN PHD†; FEUERBACH, STEFAN MD*

Section Editor(s): Runge, Val M. MD; Allison, David J. BSc, MD, MRCP, FRCR; Bradley, William G. Jr. MD, PhD, FACR; Claussen, Claus D. MD; Dietrich, Rosalind B. MB, ChB; Dondelinger, Robert F.; Eckelman, William C. PhD; Felix, Roland MD; Finn, Paul MD; Gore, John C. PhD; Gourtsoyiannis, Nicholas C. MD; Imhof, Herwig MD; Krestin, Gabriel P. MD; Lamont, A. C. FRCR; Lufkin, Robert B. MD; Manelfe, Claude MD; Muller, Robert N. PhD; Muroff, Lawrence R. MD, FACR; Nelson, Kevin L. MD; Passariello, Roberto MD; Pettigrew, Roderic I. PhD, MD; Ross, Jeffrey S. MD; Rossi, Plinio MD, FACR; Smith, Francis W. MD; Speck, Ulrich MD; Stark, David D. MD; Strauss, H. William MD; Struyven, Julien L. MD; Sze, Gordon K. MD; Tweedle, Michael F. PhD; Van Voorthuisen, ; Wood, Michael L. PhD; Worthington, Brian S. MD

Original Investigations

rationale and objectives The authors evaluate a new flat-panel x-ray detector (FD) with respect to foreign body detection and reduction of radiation dose compared with screen-film radiography.

methods Flat-panel x-ray detector is based on amorphous silicon technology and uses a 1 k x 1 k photo-detector matrix with a pixel size of 143 x 143 µm and 12-bit digital output. A thallium-doted cesium iodide scintillation layer converts x-rays into light. An ex vivo experimental model was used to determine the detectability of foreign bodies. Foreign bodies with varying sizes were examined: glass with and without addition of lead, bone, aluminium, iron, copper, gravel fragments, and graphite. Four hundred observation fields were examined using conventional radiography(speed, 400; system dose: 2.5 µGy) as well as FD with a simulated speed of 400, 800, 1200, and 1600, corresponding to a detector dose of 2.5 µGy, 1.25 µGy, 0.87 µGy, and 0.625µGy, respectively. Four independent radiologists performed receiver operating characteristic analysis of 8000 observations.

results Flat-panel x-ray detector with a simulated speed of 400 was significantly superior (P = 0.012) to screen-film radiography (speed, 400). At a simulated speed of 800 and 1200 FD yielded results equivalent to screen-film radiography. Flat-panel x-ray detector was significantly inferior to screen-film radiography at a simulated speed of 1600 (P = 0.012).

conclusions Flat-panel x-ray detector technology allows significant reduction in radiation dose compared with screen-film radiography without loss of diagnostic accuracy.

Reprint requests: Markus Völk, MD, Department of Radiology, University Hospital of Regensburg, 93042 Regensburg, Germany; markus.voelk@klinik.uni-regensburg.de.

Received February 5, 1997, and accepted for publication, after revision, March 6, 1997.

From the *Department of Radiology, University Hospital of Regensburg, Regensburg, Germany, and †Siemens AG, Medical Engineering, Erlangen, Germany.

Val M. Runge, MD Lexington, Kentucky

David J. Allison, BSc, MD, MRCP, FRCR;London, United Kingdom

William G. Bradley, Jr., MD, PhD, FACR;Long Beach, California

Claus D. Claussen, MD;Tubingen, Germany

Rosalind B. Dietrich, MB, ChB;Orange, California

Prof. Robert F. Dondelinger;Liege, Belgium

William C. Eckelman, PhD;Bethesda, Maryland

Roland Felix, MD;Berlin, Germany

Paul Finn, MD;Iselin, New Jersey

John C. Gore, PhD;New Haven, Connecticut

Nicholas C. Gourtsoyiannis, MD;Crete, Greece

Herwig Imhof, MD;Vienna, Austria

Gabriel P. Krestin, MD;Zurich, Switzerland

A. C. Lamont, FRCR;Queensland, Australia

Robert B. Lufkin, MD;Los Angeles, California

Claude Manelfe, MD;Toulouse, France

Robert N. Muller, PhD;Mons, Belgium

Lawrence R. Muroff, MD, FACR;Tampa, Florida

Kevin L. Nelson, MD;Omaha, Nebraska

Roberto Passariello, MD;Rome, Italy

Roderic I. Pettigrew, PhD, MD;Atlanta, Georgia

Jeffrey S. Ross, MD;Cleveland, Ohio

Plinio Rossi, MD, FACR;Rome, Italy

Francis W. Smith, MD;Foresterhill, Scotland

Ulrich Speck, MD;Berlin, Germany

David D. Stark, MD;Omaha, Nebraska

H. William Strauss, MD;Stanford, California

Julien L. Struyven, MD;Brussels, Belgium

Gordon K. Sze, MD;New Haven, Connecticut

Michael F. Tweedle, PhD;Princeton, New Jersey

Ad E. Van Voorthuisen, MD;Oeglsgeest, Netherlands

Michael L. Wood, PhD;Toronto, Ontario

Brian S. Worthington, MD;Nottingham, England

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