Efficacy of a new detector automatic exposure control in portable anteroposterior chest radiography: a retrospective examination of radiation dose optimization and image quality

BackgroundAutomatic exposure control (AEC) devices are necessary to reduce the radiation dose and enhance image quality in radiography. However, AEC devices are not being used in portable X-ray systems due to technical issues.PurposeTo evaluate the radiation dose and image quality of a new AEC for a wireless portable X-ray system compared to the standard fixed radiation dose of manual controls in chest radiography.Material and MethodsThis retrospective analysis evaluated the performance of a portable X-ray system equipped with software-based AEC on anteroposterior chest radiographs. A quantitative evaluation comparing the manual and AEC groups was conducted to ascertain the exposure index (EI) and dose-area product (DAP). We performed observer-based analysis of image quality for lowest exposure and average exposure images in the manual and AEC groups.ResultsOverall, 2093 examinations were conducted in 467 patients. AEC yielded a statistically significant reduction in the DAP (AEC: 1.64 dGycm²; manual: 1.99 dGycm²) and EI (AEC: 266; manual: 393) compared to manual control (<i>P</i> <0.001). Evaluation of the average and low exposure images revealed that the DAP and EI were consistently lower in the AEC group (<i>P</i> <0.01). Observer-based analysis of the lowest exposure images revealed that AEC yielded a statistically significant higher score compared to manual control (12.5 manual, 13.4 AEC; <i>P</i> <0.001).ConclusionAEC within a wireless portable X-ray system improves subjective image quality while reducing radiation exposure, as substantiated by quantitative and qualitative metrics.