The Potential Role of Grid-Like Software in Bedside Chest Radiography in Improving Image Quality and Dose Reduction: An Observer Preference Study

Objective: To compare the observer preference of image quality and radiation dose between non-grid, grid-like, and grid images. Materials and Methods: Each of the 38 patients underwent bedside chest radiography with and without a grid. A grid-like image was generated from a non-grid image using SimGrid software (Samsung Electronics Co. Ltd.) employing deep-learning-based scatter correction technology. Two readers recorded the preference for 10 anatomic landmarks and the overall appearance on a five-point scale for a pair of non-grid and grid-like images, and a pair of grid-like and grid images, respectively, which were randomly presented. The dose area product (DAP) was also recorded. Wilcoxon's rank sum test was used to assess the significance of preference. Results: Both readers preferred grid-like images to non-grid images significantly (p < 0.001); with a significant difference in terms of the preference for grid images to grid-like images (p = 0.317, 0.034, respectively). In terms of anatomic landmarks, both readers preferred grid-like images to non-grid images (p < 0.05). No significant differences existed between grid-like and grid images except for the preference for grid images in proximal airways by two readers, and in retrocardiac lung and thoracic spine by one reader. The median DAP were 1.48 (range, 1.37-2.17) $dGy*cm^2$ in grid images and 1.22 (range, 1.11-1.78) $dGy*cm^2$ in grid-like images with a significant difference (p < 0.001). Conclusion: The SimGrid software significantly improved the image quality of non-grid images to a level comparable to that of grid images with a relatively lower level of radiation exposure.