A Comparative Study of Image Quality and Radiation Dose in Chest Radiography Using Different Tube Voltage Techniques : A Case Study at Bangplee Hospital

Abstract

Purposes: This study aimed to compare the image quality and entrance surface air kerma (ESAK) in chest radiography using different tube potentials of 95, 105, and 120 kVp

Study design: Quasi-Experimental Designs.

Materials and Methods: This cross-sectional experimental study included 180 patients who underwent chest PA upright radiography, divided equally into three groups (95, 105, and 120 kVp, 60 patients each). Image quality was assessed by three radiologists using predefined criteria. The deviation index (DI) was recorded, and ESAK was measured for each group.

Main findings: The mean ESAK values for 95, 105, and 120 kVp were 0.40, 0.49, and 0.25 mGy, respectively. The 120 kVp technique produced the lowest radiation dose, which was 37.50% and 48.97% lower than those of 95 and 105 kVp, respectively, and significantly lower than the national diagnostic reference level of Thailand (0.4 mGy) (p < .001). Most DI values were within the acceptable range (±3). Radiologists’ satisfaction with image quality was high in all groups, with the 120 kVp group achieving the highest satisfaction (100% rated as excellent).

Conclusion and recommendations: Chest radiography performed at 120 kVp significantly reduces patient radiation dose without compromising diagnostic image quality. This technique is recommended for chest radiography in Bangplee Hospital and can be applied in other healthcare facilities.