The aim of this study was to evaluate sensor noise with the use of the subtraction method in radiographs captured with three direct digital intraoral systems. Ten radiographs were taken of the lower left molar region of a phantom head at each of three exposure times: 0.20 seconds, 0.46 seconds, and 0.60 seconds with the use of the RadioVisioGraphy (Trophy Radiologie, Vincennes, France), Sens-a-Ray (Regam Medical Systems, AB, Sundsvall, Sweden), and Visualix (Gendex, Philips Medical Systems, Inc., Monza, Italy) systems. Neither the x-ray tube nor the phantom were moved between exposures, and the three sensors were identically positioned. The images were stored in the tagged image file format provided by the systems in 8-bit depth and imported by a subtraction program. Subtractions were performed between identical images taken with the three systems. The standard deviation for the distribution of the shades of grey in the subtraction image histogram served as an expression for image noise. Pairedt tests evaluated differences between the standard deviations of the subtraction images from the three systems. The standard deviation increased with increasing exposure time for all three systems (p < 0.00001). The standard deviation for the images performed with Visualix were 6.47, 10.34, and 11.16 at exposure times 0.20, 0.46, and 0.60, respectively. For the RadioVisioGraphy, these values were 1.61, 2.03, and 2.18, and for Sens-a-Ray 2.90, 3.98, and 3.96, respectively. The differences between the systems were highly statistically significant (p < 0.0001). Subjectively judged, the density of images taken with the Visualix system at 0.20 seconds was comparable to images taken with the RadioVisioGraphy system at 0.46 seconds and with the Sens-a-Ray at 0.60 seconds. The fastest system thus provided the most noisy images.
Read full abstract