Dose reduction and adequate image quality in digital radiography: a contradiction?

Dose reduction and adequate image quality in digital radiography - a contradiction? Digital radiography has already replaced traditional screen-film systems. Substantial improvements in both dose efficiency and spatial resolution demonstrate the rapid developments in digital radiography. Needle-detector systems have shown up to a 50% dose reduction compared to traditional screen-film systems. There is also a dose reduction capability of up to 50% comparing direct radiography (DR) systems to computed radiography (CR) systems for chest X-rays. However, despite the most recent achievements of CR technology, the dose efficiency of DR systems (caesium iodide flat-panel detector) is unparalleled. The progress in detector technology has contributed to dose reduction and improved image quality, while saving time and providing a higher examination rate. The use of dose indicators and longitudinal dose control are important to avoid substantial accidental dose increase. The dose applied to patients should fall markedly below the defined diagnostic reference levels within the European Union. Regular quality control, as well as continuous education and training of medical and technical personnel, contribute to ensure that the ALARA (as low as reasonably achievable) principle is consistently followed.