Image Quality and Entrance Surface Dose Evaluation of Lateral Cervical Spine: A Study Using Grid and Non-Grid Techniques

Introduction: The purpose of this study is to investigate the effects of grid and non-grid techniques in the lateral cervical spine radiography on image quality and entrance surface dose (ESD). Although image quality and radiation doses have been studied by researchers, there is still a dearth of information on image quality and patient dose with different techniques. Material and Methods: The radiographs of the lateral cervical spine were acquired by positioning the RANDO phantom abutting the erect bucky while using the grid and non-grid techniques. This study benefited from using a 24 cm x 30 cm Fuji standard cassette type imaging plate. A Leeds TOR test tool was utilized for relative comparison of image quality. The ESD of each examination was determined by using the optically stimulated luminescence dosimeter. Results: The increased kilovoltage (kVp) resulted in the reduction of ESD whether moving grid, stationary grid, or non-grid techniques were utilized. Significant differences in terms of contrast sensitivity and spatial resolution were indicated when comparing the grid technique to that of the non-grid technique (i.e., χ2=8 and 5, ). The results also indicated significant differences in ESD when using the moving grid, stationary grid, and non-grid techniques (i.e., χ2=7.2, ). Conclusion: Significant differences in image quality and ESD were indicated when grid and non-grid techniques were used in the lateral cervical spine radiography. A non-grid with the highest appropriate kVp is recommended as the air gap acts as a grid, resulting in acceptable image quality with reduction in ESD.