Need for New Optimisation Strategies in CR and Direct Digital Radiography

Digital imaging techniques such as Digital Image Intensifier Radiography and Digital Storage Phosphor (Selenium) Radiography are replacing conventional film-screen radiography more and more. The aim of this development is the extension of diagnostic capabilities and the reduction of side effects such as radiation dose. Conventional film-screen radiography and digital radiography are very different ways of imaging. For digital radiography specific post-processing is the link between imaging conditions and film documentation. Optimisation of the images includes new possibilities of post-processing and a broad range for variation of the dose. Especially in fluoroscopy, dose can be reduced significantly by new technical features like pulsed fluoroscopy. For digital radiography the European guidelines on quality criteria have to be applied to projection radiography, digital subtraction radiography and to fluoroscopy. Further work should lead to a definition of reference values for the dose and the image quality. This has to be done first for single exposures and fluoroscopic mode and secondly for diagnostic and interventional procedures. (author)