AEC testing in a CR environment

Full text: Testing of x-ray machine automatic exposure control (AEC) functionality for varying kVp and patient thickness is a fundamental health physics check. Current test protocols tend to be based on testing in a film environment using film optical density as the measure of conformance. With the move into the digital x-ray image age with the use of computed radiography (CR) and digital radiography (DR) equipment and its associated image storage and retrieval system (PACS) a new AEC testing protocol is required. All CR systems provide a dose assessment tool (called Exposure Index or EI by Kodak) that could be used as a surrogate for optical density. However this work aims to derive an efficient means of assessing the functioning of the AEC of x-ray machines in a CR environment using dose measurement alone. This would eliminate the need to process the many image plates normally required for AEC testing in order to obtain and analyse the exposure measure from the CR system. The EI, and other brand's equivalents, is calibrated for a given condition (for Kodak 80kVp 0.5mmCu + 1mmAl). In order to use dose measurement alone the relationship between EI and dose must be known for varying kVp and patient thicknesses (represented by a perspex phantom). This will depend on the response of the CR plate to varying beam energies. This was assessed using a series of paired exposures at various kVp and perspex thicknesses. In the first exposure of each pair a Kodak CR plate was used, processed in the normal way, and the EI noted. In a second identical exposure an Innovision 35050A pancake ionization chamber was placed in the bucky tray within a specially modified film cassette and the dose measured. Over the 50-125kVp range of clinical use the kV response of the Kodak PSP's shown below is essentially flat for a set dose to the image plate and filtered using the standard Kodak method of 0.5mmCu + 1mmAl. Similar data will be presented showing this relationship using a perspex phantom and also for EI with varying Perspex phantom thickness. A correctly operating AEC system in a CR environment should result in consistent image quality over the clinical range. This can presumably be represented by minimal variation in Exposure Index reported by the CR system. Given the measured relationship between dose and Exposure Index it may be possible to use dose measurement as a direct measure of AEC performance. Setting appropriate tolerances for dose means considering the El-dose relationship (El ∝ x log (dose)), the calibration accuracy of EI, and traditional tolerances accepted as reasonable in a film environment. These considerations will be discussed in detail during the presentation. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine