Beam quality independent attenuation phantom for estimating patient exposure from x-ray automatic exposure controlled chest examinations

Abstract

The periodic assessment of exposures in diagnostic radiology is an important part of a comprehensive quality assurance program. The most frequent radiologic examination conducted in the USA is chest radiography. Automatic exposure controlled (AEC) techniques are often used for this exam, and a standard patient-equivalent chest phantom is useful when estimating patient exposures on such systems. This is of particular importance if exposures are to be compared among AEC systems with different entrance X-ray spectra. Such a phantom has been developed to facilitate surveys of the average patient exposure from AEC posteroanterior chest radiography. The phantom is relatively lightweight and easily transportable, sturdy and made of readily available and relatively inexpensive materials (Lucite and aluminum). It accurately simulates the primary and scatter transmission through the lung-field regions of a patient-equivalent anthropomorphic phantom for X-ray spectra typically used in chest radiography. A clinical evaluation was conducted to verify the patient equivalence of the phantom. Measurements of patient entrance skin exposure were obtained for a large number of patients on a variety of X-ray systems operated in the AEC mode using one or both lung-field detectors. Comparison of these data with exposure estimates derived from the phantom indicate that the phantom attenuates the X-ray beam in such a way that it can be employed to accurately and consistently estimate the mean exposure of the average patient under a variety of radiographic conditions. The design, development, and evaluation of the patient-equivalent attenuation phantom is described.