Analysis of Image Quality, Anatomical Information, and Dose Consistency Across Variations in kV Exposure Factors in Portable X-ray
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Tuberculosis (TB) remains a significant global health problem, with Indonesia ranking second in the world for new cases. Chest radiography is indispensable for screening and diagnosis, especially when portable X-ray devices operate in isolated settings. Getting exposure parameters right matters a great deal for producing diagnostically adequate images while limiting radiation doses as much as reasonably possible (ALARA). We intend to determine how shifting kilovoltage changes image quality, how much anatomy is captured, and how consistently the dose holds up across two portable X-ray modalities. This experimental study used an anthropomorphic thorax phantom. Exposures were performed on two portable X-ray modalities (Modality 1: 50-90 kV, 5 mA; Modality 2: 40-70 kV, 2-6 mA) with variations in kV (50, 60, 70) and mAs (0.5; 1; 1.6; 2; 2.5). To quantify image performance, we determined the Exposure Index (EI), Signal-to-Noise Ratio (SNR), and Contrast-to-Noise Ratio (CNR) across ROIs spanning the lungs, hilum, cardiac area, and ribs. Dose consistency was measured using a Raysafe survey meter. kV and mAs variations significantly affected EI, SNR, and CNR values in both modalities. Modality 1 showed higher SNR and CNR in most organs, while Modality 2 excelled in soft tissue visualization (Cardiac) at high exposure. The optimal exposure factor combination for Modality 1 was 70 kV, 1.6-2.0 mAs (lung SNR >300, dose 0.027-0.034 mGy). For Modality 2, the optimal combination was 70 kV, 1.6 mAs (lung SNR 75.95, dose 0.02155 mGy). The two recommendations produced doses below the national Diagnostic Reference Level (DRL) set at 0.4 mGy. The optimal exposure factor for TB chest examinations with portable X-ray is 70 kV with mAs variations adjusted to the modality's characteristics. This recommendation produces good diagnostic image quality while minimizing patient radiation dose, in accordance with the ALARA principle.
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Copyright (c) 2026 Fatimah Fatimah, Nanang Sulaksono, Dwi Rochmayanti, Darmini Darmini, Dartini Dartini, Yeti Kartikasari, Dimas Prakoso, Salis Nurbaiti, Afif Akhsani, Hengky Saiefulloh, Sofyan Fauzi (Author)
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