In 2012, Germany was the first country to have regulatory demands that all manufacturers are to have Exposure Index for digital X-ray units sold in the country, a trend that more countries will follow in the coming years as Exposure Index brings quality assurance to digital X-ray examinations.

Today's state-of-the-art exposure index will adapt to the actual tissue being imaged, allowing for improved accuracy and reliability.


With image quality, manufacturers adjust to ensure the best image possible is available, but image tastes can differ a lot between continents, countries and even between doctors at the same clinic, so technology that allows doctors to modify image quality is essential.

One of the advantages with digital imaging is that OEMs develop or buy image enhancement software and tune the image into specific taste that fit the market. Now OEMs also offer the clinicians the possibilities to do the same, adjust the image to their preference locally. This is a feature that first originated with the ultrasound clinicians but now the product has spread to the X-ray field so technicians and doctors can adjust the image enhancement to their taste to optimize the reading.

X-ray Tomorrow

The demand of image quality will continue to set higher levels of standards, making the need of standardization more important. Image control will be provided to the end-user in a broader range. For instance a radiologist can make adjustment to the image so he/she can see the details that he/she needs to make a proper diagnosis. Then comes the second opinion of another radiologist who wants the image to look slightly different and can make these adjustments directly into the image. Therefore, image control will be more important.

The question is who will have this control? Can the manufacturers "give up" the image control to the clinical users? Do the end users really want a variety of choices or just a one-button machine? How much will the different tastes differ? Will there be an international common view of what a "good image quality" is? When it comes to dose control, how little dose will be necessary in the future to get a good image? The future brings enhanced image quality with minimum use of radiation, possibly with mathematical simulation algorithms for noise subtraction. Quality of image is determined by the number of pixels - higher the pixels, higher will be the quality. But high numbers of pixels also causes high noise, so what will the low dose noise limit be? Today there already are good image enhancement products available to take care of this problem. In the future, the image enhancement software will be even more sophisticated, making it possible for the manufacturers to mesh this software even more seamless and with less hardware resources.

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