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Radiation dose to patients and its management have become important considerations in modern radiographic imaging procedures, but they acquire particular significance in the imaging of children. Because of their longer life expectancy, children exposed to radiation are thought to have a significantly increased risk of radiation-related late sequelae compared to adults first exposed to radiation later in life. Therefore, current clinical thinking dictates that dose in pediatric radiography be minimized, while simultaneously ensuring sufficient diagnostic information in the image, and reducing the need for repeat exposures. Dose management obviously starts with characterization and control of the exposure technique. However, it extends farther through the imaging chain to the acquisition system, and even to the image processing techniques used to optimize acquired images for display. Further, other factors, such as quality control procedures and the ability to handle special pediatric procedures, like scoliosis exams, also come into play. The need for dose management in modern radiography systems has spawned a variety of different solutions, some of which are similar across different manufacturers, and some of which are unique. This paper covers the techniques used in Agfa Computed Radiography (CR) systems to manage dose in a pediatric environment.

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At Agfa Medical Imaging Systems, a new type of image plate scanner is being developed. Instead of scanning the irradiated image plate with a single laser and reading the luminescence information with a single light collector and photomultiplier, the new system employs a whole line of laser diodes and a set of CCD line sensors. This technique allows for virtually unlimited detection areas and a very fast readout.

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Digital radiography (DR) has become integral to modern diagnostic radiology. One of the earliest forms of DR, computed radiography (CR) using storage phosphors, has established itself as the mainstay of DR-based diagnostic imaging over the past 20 years. More recently, flat-panel DR systems based on solid state X-ray detectors with integrated, large-area, active-matrix readout electronics are promising further improvements in clinical workflow and image quality. Despite CR's longevity, innovations continue to be made. New developments in CR screen technologies, like structured (needle) screens, and new scanner concepts based on line-at-a-time reading promise major improvements in image quality (comparable to that of flat-panel systems), system through-put and physical size, at a cost comparable to that of today's systems. Thus, despite the advent of flat-panel acquisition systems, there will still be an important role for CR in the foreseeable future. After a brief review of the current state of CR technology, this paper will explore several of these new CR developments and present some examples of their potential clinical impact.

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This article describes the current status and potential applications of high-resolution storage phosphor for imaging of the chest. Digital imaging that uses storage phosphor technology is easily adaptable to existing x-ray--generating equipment and can also be used with mobile equipment. The wide latitude of the storage phosphor technique permits satisfactory imaging in situations in which exposure factors cannot be accurately estimated or easily controlled. Early experience with an experimental Kodak high-resolution (4K x 4K) storage phosphor system suggests that standard and portal chest images of excellent quality can be obtained. Many issues must be resolved, however, before digital radiology with a storage phosphor can be advocated as being preferable to conventional film-screen systems. These issues, which include display modalities (film or television monitor), resolution requirements, and the effects of image processing, can only be resolved by further large-scale accuracy studies. The change to a digital imaging system will involve major expenditures for equipment and computers. Cost will be related largely to the level of spatial resolution required for primary radiographic diagnosis.

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A technique for automatic anatomically selective enhancement of digital chest radiographs is developed. Anatomically selective enhancement is motivated by the desire to simultaneously meet the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm and a set of rules are applied to the image histogram to determine automatically a gray-level threshold between the lung field and mediastinum. The gray-level threshold facilitates anatomically selective gray-scale modification and/or unsharp masking. Further, in an attempt to suppress possible white-band or black-band artifacts due to unsharp masking at sharp edges, local contrast adaptively is incorporated into anatomically selective unsharp masking by designing an anatomy-selective emphasis parameter which varies asymmetrically with positive and negative values of the local image contrast.