• Title/Summary/Keyword: Imaging method

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Optimization of Subtraction Brain Perfusion SPECT with Basal/Acetazolamide Consecutive Acquisition (기저/아세타졸아미드 부하 연속 촬영 뇌관류 SPECT 최적화)

  • Lee, Dong-Soo;Lee, Tae-Hoon;Kim, Kyeong-Min;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.330-338
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    • 1997
  • This study investigated the method to adjust acquisition time(a) and injection dose (i) to make the best basal and subtraction images in consecutive SPECT. Image quality was assumed to be mainly affected by signal to noise ratio(S/N). Basal image was subtracted from the second image consecutively acquired at the same position. We calculated S/N ratio in basal SPECT images($S_1/N_1$) and subtraction SPECT images(Ss/Ns) to find a(time) and i(dose) to maximize S/N of both images at the same time. From phantom images, we drew the relation of image counts and a(time) and i(dose) in our system using fanbeam-high-resolution collimated triple head SPECT. Noise by imaging process depended on Poisson distribution. We took maximum tolerable duration of consecutive acquisition as 30 minutes and maximum injectible dose as 1,850MBq(50 mCi)(sum of two injections) per study. Counts of second-acquired image($S_2$), counts($S_s$) and noise($N_s$) of subtraction SPECT were as follows. $C_1$ was the coefficient of measurement with our system. $$S_2=S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{30-a}{a})+C_1{\cdot}(30-a){\cdot}{\epsilon}{\cdot}(50-i)$$ $$Ss=S_2-\{S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{(30-a)}{a})\}$$ $$Ns={\sqrt{N_2^2+N_1^2{\cdot}\frac{(30-a)^2}{a^2}}={\sqrt{S_2+S_1{\cdot}\frac{(30-a)^2}{a^2}}$$ In case of rest/acetazolamide study, effect(${\epsilon}$) of acetazolamide to increase global brain uptake of Tc-99m-HMPAO could be 1.5 or less. Varying ${\epsilon}$ from 1 to 1.5, a(time) and i(dose) pair to maximize both $S_1/N_l$ and Ss/Ns was determined. 15 mCi/17 min and 35mCi/13min was the best a(time) and i(dose) pair for rest/acetazolamide study(when ${\epsilon}$ were 1.2) and came to be used for our clinical routine after this study. We developed simple method to maximize S/N ratios of basal and subtraction SPECT from consecutive acquisition. This method could be applied to ECD/HMPAO and brain activation studies as well as rest/acetazolamide studies.

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Airway Responses to Bronchoprovocation Using High-Resolution Computed Tomography in Patients with Bronchial Asthma (기관지천식환자에 있어서 고해상도 전산화단층촬영술을 이용한 기관지유발에 대한 기도의 반응)

  • Choi, Byoung-Whui;Kang, Yoon-Jeong;Ko, Hyung-Ki;Park, In-Won;Hue, Sung-Ho;Kim, Yang-Soo;Kim, Young-Goo;Kim, Kun-Sang;Kim, Jong-Hyo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.813-822
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    • 1995
  • Background: Bronchial hyperresponsiveness and abnormal response such as a loss of distensibility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. Method: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in $FEV_1$) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. Results: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter <2 mm; area < $3.14mm^2$) was 48.7%(8.3; SEM, n=43), being more prominant than that of large airways(average diameter >2 mm; area > $3.14mm^2$), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). Conclusions: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.

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Optimization of GFR value according to Kidney Depth Measurement Methods (신장 Depth 측정 방법에 따른 GFR 값의 최적화)

  • Kwon, Hyeong-Jin;Moon, Il-Sang;Noh, Gyeong Woon;Kang, Keon Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.25-28
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    • 2019
  • Purpose In patients with unusual kidney position after $^{99m}Tc-DTPA$ renal dynamic imaging study, the GFR(Glomerular Filtration Rate) values are significantly different according to the depth of the kidney. Thus, we tried to compare the difference of the GFR values between the depth measurement methods and in-vitro test. 30 adult patients who were subjected to renal study. 27 patients were in usual position and 3 patients were in unusual. $555{\pm}37MBq$ of $^{99m}Tc-DTPA$ was administrated to all patients. GE infinia gamma camera was used. GFR values were obtained in-vivo(gates method) and in-vitro(blood). The kidney depth in-vivo was calculated by three methods(tonnensen, manual, taylor). In-vitro, GFR was performed by blood test. Differences in the mean values of GFR and correlation between depth and GFR values were evaluated using the SPSS 12.0 statistical program. The GFR values for 27 patients with kidney in the usual position are as follows(1.tonnensen 2.manual 3.taylor 4.invitro); $69.3{\pm}4.2$, $88.2{\pm}5.6$, $77.8{\pm}4.3$, $82.2{\pm}5.8ml/min$. The three unusual cases are as follows, first(congenital renal anomaly): 66.4, 101.24, 69.07, 94.8 ml/min. second(transplantation kidney): 12.22, 29.99, 19.36, 23.5 ml/min. third(horseshoe kidney): 37.37, 93.54, 35.9, 92.5 ml/min. There was a difference between tonnensen and manual in the usual position of the kidney(p<0.05). There was no significant difference between the other methods. However, there was a significant difference in case of the unusual position of the kidneys. Correlation analysis between both kidney depth and GFR value shows person correlation as follows; Rt kidney: 0.298, Lt kidney: 0.322. When compared with the GFR values in-vitro test, it was useful to calculate the GFR value by measuring the kidney depth using a manual formula in the unusual position of the kidneys. GFR values and kidney depth were significantly related.

Truncation Artifact Reduction Using Weighted Normalization Method in Prototype R/F Chest Digital Tomosynthesis (CDT) System (프로토타입 R/F 흉부 디지털 단층영상합성장치 시스템에서 잘림 아티팩트 감소를 위한 가중 정규화 접근법에 대한 연구)

  • Son, Junyoung;Choi, Sunghoon;Lee, Donghoon;Kim, Hee-Joung
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.111-118
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    • 2019
  • Chest digital tomosynthesis has become a practical imaging modality because it can solve the problem of anatomy overlapping in conventional chest radiography. However, because of both limited scan angle and finite-size detector, a portion of chest cannot be represented in some or all of the projection. These bring a discontinuity in intensity across the field of view boundaries in the reconstructed slices, which we refer to as the truncation artifacts. The purpose of this study was to reduce truncation artifacts using a weighted normalization approach and to investigate the performance of this approach for our prototype chest digital tomosynthesis system. The system source-to-image distance was 1100 mm, and the center of rotation of X-ray source was located on 100 mm above the detector surface. After obtaining 41 projection views with ${\pm}20^{\circ}$ degrees, tomosynthesis slices were reconstructed with the filtered back projection algorithm. For quantitative evaluation, peak signal to noise ratio and structure similarity index values were evaluated after reconstructing reference image using simulation, and mean value of specific direction values was evaluated using real data. Simulation results showed that the peak signal to noise ratio and structure similarity index was improved respectively. In the case of the experimental results showed that the effect of artifact in the mean value of specific direction of the reconstructed image was reduced. In conclusion, the weighted normalization method improves the quality of image by reducing truncation artifacts. These results suggested that weighted normalization method could improve the image quality of chest digital tomosynthesis.

The Evaluation of Attenuation Difference and SUV According to Arm Position in Whole Body PET/CT (전신 PET/CT 검사에서 팔의 위치에 따른 감약 정도와 SUV 변화 평가)

  • Kwak, In-Suk;Lee, Hyuk;Choi, Sung-Wook;Suk, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.21-25
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    • 2010
  • Purpose: For better PET imaging with accuracy the transmission scanning is inevitably required for attenuation correction. The attenuation is affected by condition of acquisition and patient position, consequently quantitative accuracy may be decreased in emission scan imaging. In this paper, the present study aims at providing the measurement for attenuation varying with the positions of the patient's arm in whole body PET/CT, further performing the comparative analysis over its SUV changes. Materials and Methods: NEMA 1994 PET phantom was filled with $^{18}F$-FDG and the concentration ratio of insert cylinder and background water fit to 4:1. Phantom images were acquired through emission scanning for 4min after conducting transmission scanning by using CT. In an attempt to acquire image at the state that the arm of the patient was positioned at the lower of ahead, image was acquired in away that two pieces of Teflon inserts were used additionally by fixing phantoms at both sides of phantom. The acquired imaged at a were reconstructed by applying the iterative reconstruction method (iteration: 2, subset: 28) as well as attenuation correction using the CT, and then VOI was drawn on each image plane so as to measure CT number and SUV and comparatively analyze axial uniformity (A.U=Standard deviation/Average SUV) of PET images. Results: It was found from the above phantom test that, when comparing two cases of whether Teflon insert was fixed or removed, the CT number of cylinder increased from -5.76 HU to 0 HU, while SUV decreased from 24.64 to 24.29 and A.U from 0.064 to 0.052. And the CT number of background water was identified to increase from -6.14 HU to -0.43 HU, whereas SUV decreased from 6.3 to 5.6 and A.U also decreased from 0.12 to 0.10. In addition, as for the patient image, CT number was verified to increase from 53.09 HU to 58.31 HU and SUV decreased from 24.96 to 21.81 when the patient's arm was positioned over the head rather than when it was lowered. Conclusion: When arms up protocol was applied, the SUV of phantom and patient image was decreased by 1.4% and 9.2% respectively. With the present study it was concluded that in case of PET/CT scanning against the whole body of a patient the position of patient's arm was not so much significant. Especially, the scanning under the condition that the arm is raised over to the head gives rise to more probability that the patient is likely to move due to long scanning time that causes the increase of uptake of $^{18}F$-FDG of brown fat at the shoulder part together with increased pain imposing to the shoulder and discomfort to a patient. As regarding consideration all of such factors, it could be rationally drawn that PET/CT scanning could be made with the arm of the subject lowered.

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Biodistribution of 3-[$^{131}I$]iodo-O-methyl-L-${\alpha}$-methyltyrosine in Tumor Bearing Rats: A Comparison Study with L-3-[$^{131}I$]iodo-${\alpha}$-methyltyrosine (종양 이식 백서에서 3-[$^{131}I$iodo-O-methyl-L-${\alpha}$-methyltyrosine의 체내 동태 연구: L-3-[$^{131}I$iodo-${\alpha}$-methyltyrosine와 비교)

  • Choi, Chang-Woon;Yang, Seung-Dae;Woo, Kwang-Sun;Chung, Wee-Sup;Lim, Soo-Jung;Suh, Yong-Sup;Chun, Kwon-Soo;Ahn, Soon-Hyuk;Lee, Jong-Doo;Hong, Sung-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.290-297
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    • 1998
  • Purpose : The aim of this study was to evaluate the feasibility of 3-[$^{131}I$]iodo-O-methyl-L-${\alpha}$-methyltyrosine ([$^{131}I$]OMIMT) as an agent for tumor image. Materials and Methods : After synthesis of 4-O-methyl-L-${\alpha}$-methyltyrosine (OMAMT), OMAMT was labeled with [$^{131}I$] using Iodogen method. In vitro cellular uptake study was performed using 9 L gliosarcoma cells at various time points upto 4 hr. The biodistribution (five rats implanted with the 9 L gliosar-coma cells per group) was evaluated at 30 min, 2 hr, 24 hr after iv injection of 3.7 MBq [$^{131}I$]OMIMT or L-3-[$^{131}I$]iodo-${\alpha}$-methyltyrosine [$^{131}I$]IMT). Gamma camera images were obtained at 30 min, 2 hr and 24 hr. Results: [$^{131}I$]OMIMT uptake was 3.3 times and 2.5 times higher than [$^{131}I$]IMT uptake at 30 min and 60 min, respectively and same after 2 hr in in vitro study using 9L gliosarcoma cells. Maximum accumulation in tumor occurred at 30 min for both [$^{131}I$]OMIMT and [$^{131}I$]IMT in tumor bearing rats. The tumor uptake of [$^{131}I$]OMIMT was significantly higher than that of [$^{131}I$]IMT at early time point studied ($3.74{\pm}0.48$ vs $0.38{\pm}0.17%$ ID/g at 30 min and $2.40{\pm}0.17$ vs $0.24{\pm}0.03%$ ID/g at 2 hr, respectively, p<0.01). However, the tumor uptake of both radiolabels were not significantly different at 24 hr ($0.04{\pm}0.01$ vs $0.05{\pm}0.01%$ ID/g). Tumor was visualized as early as at 30 min in gamma camera images. Conclusion: These data suggested that [$^{131}I$]OMIMT might be a useful tumor imaging agent and has more advantage for the tumor imaging compared to [$^{131}I$]IMT

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Effectiveness Assessment on Jaw-Tracking in Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Esophageal Cancer (식도암 세기조절방사선치료와 용적세기조절회전치료에 대한 Jaw-Tracking의 유용성 평가)

  • Oh, Hyeon Taek;Yoo, Soon Mi;Jeon, Soo Dong;Kim, Min Su;Song, Heung Kwon;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.33-41
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    • 2019
  • Purpose : To evaluate the effectiveness of Jaw-tracking(JT) technique in Intensity-modulated radiation therapy(IMRT) and Volumetric-modulated arc therapy(VMAT) for radiation therapy of esophageal cancer by analyzing volume dose of perimetrical normal organs along with the low-dose volume regions. Materials and Method: A total of 27 patients were selected who received radiation therapy for esophageal cancer with using $VitalBeam^{TM}$(Varian Medical System, U.S.A) in our hospital. Using Eclipse system(Ver. 13.6 Varian, U.S.A), radiation treatment planning was set up with Jaw-tracking technique(JT) and Non-Jaw-tracking technique(NJT), and was conducted for the patients with T-shaped Planning target volume(PTV), including Supraclavicular lymph nodes(SCL). PTV was classified into whether celiac area was included or not to identify the influence on the radiation field. To compare the treatment plans, Organ at risk(OAR) was defined to bilateral lung, heart, and spinal cord and evaluated for Conformity index(CI) and Homogeneity index(HI). Portal dosimetry was performed to verify a clinical application using Electronic portal imaging device(EPID) and Gamma analysis was performed with establishing thresholds of radiation field as a parameter, with various range of 0 %, 5 %, and 10 %. Results: All treatment plans were established on gamma pass rates of 95 % with 3 mm/3 % criteria. For a threshold of 10 %, both JT and NJT passed with rate of more than 95 % and both gamma passing rate decreased more than 1 % in IMRT as the low dose threshold decreased to 5 % and 0 %. For the case of JT in IMRT on PTV without celiac area, $V_5$ and $V_{10}$ of both lung showed a decrease by respectively 8.5 % and 5.3 % in average and up to 14.7 %. A $D_{mean}$ decreased by $72.3{\pm}51cGy$, while there was an increase in radiation dose reduction in PTV including celiac area. A $D_{mean}$ of heart decreased by $68.9{\pm}38.5cGy$ and that of spinal cord decreased by $39.7{\pm}30cGy$. For the case of JT in VMAT, $V_5$ decreased by 2.5 % in average in lungs, and also a little amount in heart and spinal cord. Radiation dose reduction of JT showed an increase when PTV includes celiac area in VMAT. Conclusion: In the radiation treatment planning for esophageal cancer, IMRT showed a significant decrease in $V_5$, and $V_{10}$ of both lungs when applying JT, and dose reduction was greater when the irradiated area in low-dose field is larger. Therefore, IMRT is more advantageous in applying JT than VMAT for radiation therapy of esophageal cancer and can protect the normal organs from MLC leakage and transmitted doses in low-dose field.

Comparative evaluation for leaf position accuracy according to gantry angle variation in MLC quality assurance using electronic portal imaging device(EPID) and GafChromic EBT3 film (전자포탈영상장치(EPID)와 GafChromic EBT3 film을 이용한 다엽콜리메이터 정도관리 시 갠트리 각도 변화에 따른 엽의 위치 정확성 비교 평가)

  • Yang, Myung Sic;Park, Ju Kyeong;Lee, Seung Hun;Lee, Sun Young;Kim, Jung Soo;Kwon, Hyoung Cheol;Kim, Yang Su
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.83-91
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    • 2017
  • Objectives: The purpose of this study was to evaluate the error of the leaf position accuracy of the MLC due to the gravity effect according to the gantry angle by using picket fence test using EPID and GafChromic EBT3 film. Materials and Methods: A 5 cm solid phantom was placed on the table and the SAD was set to 100 cm. The EBT3 film was placed exactly over the solid phantom and covered a 1.5 cm solid phantom and the picket fence test was performed. The EPID was measured under the same conditions as the EBT3 film at SID 100 cm. The gantry angles were measured at $0^{\circ}$, $90^{\circ}$, $180^{\circ}$ and $270^{\circ}$ in order to evaluate the position of the MLC according to the gantry angle. For the geometric evaluation of the MLC, the leaf position accuracy of the MLC was analyzed using the analysis program. Results: In case of EPID, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.18 mm, 0.31 mm, 0.20 mm, 0.26 mm on the average and the maximum values of the errors were respectively 0.44 mm, 0.54 mm, 0.34 mm, 0.44 mm. In case of EBT3 film, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.19 mm, 0.21 mm, 0.19 mm, 0.31 mm on the average and the maximum values of the errors were respectively 0.35 mm, 0.45 mm, 0.36 mm, 0.48 mm. Conclusion: In this study, we analyzed the position error of the leaf of the MLC according to the gantry angle, and confirmed the position error of the leaf by gravity effect. As a result of comparing the leaf position accuracy using EPID and EBT3 film according to the variation of gantry angle, a larger error occurred in the error analysis method using EPID than that of EBT3 film. Therefore, in the case of IMRT based on MLC, as well as verification of accurate dosimetry should be conducted, it is considered that the quality control and verification for the precise operation of the MLC will be needed. and it is necessary to compare and verify the method of analysis.

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Mapping and estimating forest carbon absorption using time-series MODIS imagery in South Korea (시계열 MODIS 영상자료를 이용한 산림의 연간 탄소 흡수량 지도 작성)

  • Cha, Su-Young;Pi, Ung-Hwan;Park, Chong-Hwa
    • Korean Journal of Remote Sensing
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    • v.29 no.5
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    • pp.517-525
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    • 2013
  • Time-series data of Normal Difference Vegetation Index (NDVI) obtained by the Moderate-resolution Imaging Spectroradiometer(MODIS) satellite imagery gives a waveform that reveals the characteristics of the phenology. The waveform can be decomposed into harmonics of various periods by the Fourier transformation. The resulting $n^{th}$ harmonics represent the amount of NDVI change in a period of a year divided by n. The values of each harmonics or their relative relation have been used to classify the vegetation species and to build a vegetation map. Here, we propose a method to estimate the annual amount of carbon absorbed on the forest from the $1^{st}$ harmonic NDVI value. The $1^{st}$ harmonic value represents the amount of growth of the leaves. By the allometric equation of trees, the growth of leaves can be considered to be proportional to the total amount of carbon absorption. We compared the $1^{st}$ harmonic NDVI values of the 6220 sample points with the reference data of the carbon absorption obtained by the field survey in the forest of South Korea. The $1^{st}$ harmonic values were roughly proportional to the amount of carbon absorption irrespective of the species and ages of the vegetation. The resulting proportionality constant between the carbon absorption and the $1^{st}$ harmonic value was 236 tCO2/5.29ha/year. The total amount of carbon dioxide absorption in the forest of South Korea over the last ten years has been estimated to be about 56 million ton, and this coincides with the previous reports obtained by other methods. Considering that the amount of the carbon absorption becomes a kind of currency like carbon credit, our method is very useful due to its generality.

Image and Exposure Dose in Accordance with Radiation Quality on Plain Chest Radiography (흉부촬영(胸部撮影)에서 증감지(增感紙)-필름계의 선질변화(線質變化)에 따른 감도(感度)와 화질에 관(關)한 연구(硏究))

  • Kim, Jung-Min;Kim, Dong-Huan;Hayashi, Taro;Ishida, Yuji;Maeda, Mika;Sakura, Tatsuya
    • Journal of radiological science and technology
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    • v.15 no.1
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    • pp.65-78
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    • 1992
  • Routine chest radiography is generally imaged by high voltage technique but some radiological technologists use low voltage for imaging. High voltage is usually said between $120\;kV{\sim}140\;kV$. Some RTs like using heavy filtration but others seldom like using it. However which is better for use calcium tungustate film screen system or ortho system and high contrast film or wide latitude c-type film for the exculusive use of chest radiography. We could not make a decision which is ideal method for use. In my opinion any method is not always exellent for chest radiography. In my experiments that I had at Kaken hospital in Japan last year I expect to keep the balance between image quality and diagnostic range and to reduce radiation dose for patients. My experiments are as follows. 1. We have looked into system characteristics(speed and contrast) in accordance with kVp($80{\sim}140$) and added filter($no{\sim}1/16\;VL$) in three screen film systems(BX3+CRONEX4, SRO750+MGH, SRO750+MGL). 2. We have looked into skin dose and film dose with same D=1.8 lung field density in accordance with kVp($80{\sim}140$) and added filter($no{\sim}1/16\;VL$) in three screen film systems. 3. We have compared with the evaluation between correlation of physical image quality(MTF) and optical diagnostic capability. Result are follows. 1. Speed of BX3+CRONEX4 became higher in accodance with kVp and thickness of filter but speed of ortho system was not as like regular system. Thicker filter diminished the speed over 100 kV range in SRO750+MGL. In case of SRO750+MGH speed of 1/16VL filter was looked into lower than speed of 1/4VL filter. Sensitivity of ortho system depends on tube voltage and added filter. 2. Skin dose has been detected $225\;{\mu}Gy{\sim}66\;{\mu}Gy$ in BX3+CRONEX4 from 80 kV, no filter to 140 kV, 1/16VL filter. SRO750+MGH could reduce the patient dose $1/2{\sim}1/3$ level in comparison to that of BX3+CRONEX4. 3. The higher kV was the worse MTF became the thicker filter was the worse MTF became too. MTF of BX3+CRONEX4 was detected better than MTF of SRO750+MGH but SRO750+MGH's optical detectability of small lesion in lung field came out better than that of BX3+CRONEX4. Conclusion Recently routine chest radiography is generally imaged by high voltage but it seems to be there are some questions in using of film screen combination. In high voltage chest radiography the subject contrast will come down that means latitude become wider. In this case if we select the low contrast film screen system(C or L type) the film contrast will fall down extremly and detectability of small lesion will be deteriorated. Wide latitude C, L type film has a merit of high detectability on mediastinum. Furthermore high contrast film screen system has the advantage to keep the high contrast in low density region as like mediastinum and heart shadow. Therefore in low subject contrast high voltage chest radiography we would rather choose the high contrast film screen system(H type) I think. From a view point of patient dose detectability of mediastinum and lung field. The optimum technical facter was found out 120 kV, 1/16VL filter : BX3+CRONEX4, 140 kV, 1/4VL filter : SRO750+MGH, 100 kV, 1/4VL filter : SRO750+MGL.

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