Digital portal radiography in mantle-field irradiation

This paper evaluates the potential of digital luminescence radiography to improve image quality of portal films in mantle-field irradiation. Conventional and digital verification films of an anthropomorphic phantom and 20 patients treated for Hodgkin disease with mantle radiation therapy were obtained with high-energy photon beams. Both conventional films and storage phosphor screens were placed into a cassette with steel intensifier screens. Exposed storage phosphor screens were processed in a semiautomatic mode, with an optimized contrast curve with moderate edge enhancement, and printed as hard copies in a double-image output format. Images were evaluated according to contrast resolution, delineation of anatomic structures, and accuracy of field alignment. Digital portal radiographs were superior to conventional ones with regard to contrast resolution. Thus, they allowed quick and easy detection of relevant structures, although delineation of anatomic structures and field alignments were judged to be equivalent with both techniques. Shorter exposure times for digital images resulted in a reduction in motion artifacts