Correlation Between Contrast-Detail Analysis and Clinical Image Quality Assessment of Intrapulmonary Lesions in Dual-Energy Subtraction Chest Radiography Using the TwoShot Method: A Phantom Study

Rationale and Objectives: Dual -energy subtraction (DES) imaging constitutes a technique that has demonstrated efficacy in enhancing the detectability of pulmonary nodules on chest radiographs. However, a simple and quantitative methodology for evaluating the clinical image quality of DES images is currently lacking. The objective of this study was to investigate the applicability of contrast -detail (C -D) phantom analysis to the visual clinical image quality evaluation of chest DES images. Materials and Methods: We employed a custom-made phantom incorporating the C -D phantom and a multipurpose anthropomorphic adult chest phantom. Two phantom sizes were utilized to simulate standard- and large -bodied adult patients for each phantom. The custom-made phantom images were scored automatically using dedicated software, yielding an inverse image quality figure (IQF inv ) value. The multipurpose anthropomorphic adult chest phantom was employed in a visual grading analysis (VGA) study that was conducted by two experienced radiologists and five radiological technologists. Each nodule placed in the chest phantom image was rated on a 4 -point Likert scale. Results: A statistically significant correlation was observed between the VGA scores of the seven observers and the obtained IQF inv values. Conclusion: The findings of this study suggest that DES image analysis of the C -D phantom possesses the potential to be utilized for the evaluation of clinical DES image quality based on chest lesion detectability.