Photostimulable Phosphor Research Articles

An optical vibration sensor enabled by coupling mechanoluminescence with photostimulable phosphor

An optical vibration sensor enabled by coupling mechanoluminescence with photostimulable phosphor

Exposure of Photostimulable Phosphor Plates with Red, Blue, and Green Light: Comparing Multiple Sequences Before Scanning

Exposure of Photostimulable Phosphor Plates with Red, Blue, and Green Light: Comparing Multiple Sequences Before Scanning

Peracetic Acid Efficacy on Disinfection of Photostimulable Phosphor Plates.

To evaluate the antimicrobial efficacy of white vinegar, acetic acid and peracetic acid on photostimulable phosphor (PSP) plates disinfection, and to assess the disinfectant influence on the radiographic quality. Eight PSP plates (Express system) were contaminated with Streptococcus mutans and Candida albicans. These plates were wiped with tissues without any substance, with white vinegar, acetic acid, and peracetic acid, followed by an agar imprint. Number of microbial colonies formed was recorded. Afterwards, the quality of radiographs was tested using the more efficient disinfectant. Before disinfection and after every five disinfections, two radiographs of an acrylic-block and two radiographs of an aluminum step-wedge were acquired for each plate. Density, noise, uniformity, and contrast were analyzed. Three oral radiologists evaluated the images for the presence of artifacts. One-way Analysis of Variance compared changes on gray values among the disinfections (α = 0.05). Intra- and inter-examiner agreement for the presence of artifacts was calculated by weighted Kappa. Peracetic acid was the only one that eliminated both microorganisms. Density and uniformity decreased after 100 disinfections, and contrast changed without a pattern in the course of disinfections (P ≤ 0.05). Small artifacts were observed after 30 disinfections. Intra- and inter-examiner agreements were almost perfect. Disinfection with peracetic acid eliminated both microorganisms. However, it also affected density, uniformity and contrast of radiographs, and led to the formation of small artifacts.

Evaluation of the effects of postprocessing settings in digital bitewing radiographs on proximal caries detection.

Radiographs are an integral part of detecting proximal caries. The aim of this study was to evaluate the effect of contrast, brightness, noise, sharpness, and γ adjustment of digital intraoral radiographs on the diagnosis of proximal caries. In this in vitro study, 40 extracted teeth including 20 premolars and 20 molars with enamel lesions (white spot or dentin discoloration seen through the enamel) were mounted together in groups of eight inside the skull. Bitewing radiographic images of each dental group were obtained by a photostimulable phosphor plate sensor with exposure conditions of 8 mA, 70 kV, and 0.2 s. The images were reconstructed by the built-in software and examined by two oral and maxillofacial radiologists in various settings of contrast, brightness, sharpness, noise, and γ. The teeth were then cut mesiodistally and the presence or absence of caries was confirmed by an oral and maxillofacial pathologist using a stereomicroscope. The data were then analyzed using the κ agreement coefficient, sensitivity, specificity, and accuracy (α = .05). Adjustment of brightness and contrast led to higher diagnostic performance with an accuracy of 82.5% and 83.8 (for observers 1 and 2, respectively) and 82.5% (for both observers), respectively. Noise adjustment was the least helpful approach for diagnosis of proximal dental caries among other adjustments, with an accuracy of 78.8% and 77.5% for observers 1 and 2, respectively. Brightness and contrast setting was more efficient in improving the diagnostic potential of bitewing radiographs compared to other adjustments.

Assessment of Perception of Pain with E-Speed Film, CCD Sensor and Photostimulable Phosphor Plates for Intraoral Radiographs in Children using Three Pain Rating Scales

Abstract Background: Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales. Aim: To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong–Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS). Materials and Methods: A sample of 35 children aged 6–12 years were divided into two groups: group 1 (6–8 years) and group 2 (9–12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure. Statistical Analysis Used: A one-way analysis of variance (ANOVA) test and paired-samples t-test are used. Results: The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6–8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001). Conclusion: It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.

Proposed values for diagnostic reference levels in intraoral dental radiography in Serbia

Values for diagnostic reference levels are proposed for intraoral dental radiography in the Republic of Serbia. Proposed numbers for diagnostic reference levels were based on measurements on 119 intraoral units in clinical settings for an adult posterior bitewing X-ray. Values of 3.17 mGy, 3.11 mGy, and 1.58 mGy incident air kerma were found for image receptors film E class, charge-coupled device, and photostimulable phosphor plate, respectively. Similarly, 89.6 mGycm2, 88 mGycm2, and 44.6 mGycm2 air kerma-area products were found for the same detectors. All values are greater than those published in several other similar studies. This is especially true for charge-coupled device image receptors since this technology enables lower patient doses as reported before. This calls for urgent action to optimize intraoral dental imaging, so we present the radiographic techniques used and equipment description to help guide optimization actions.

In-vitro Diagnosis of Approximal Caries in Teeth Periapical Radiography with Different Exposure Parameters

Objective: The aim of this study was to evaluate periapical radiographs of enamel caries, dentin caries, and deep caries with exposed pulp and intact teeth obtained in vitro using photo-stimulated phosphor plates (PSP) under different exposure parameters. Methods: 3 non-carious extracted molars were selected. The obtained molars were embedded in the wax created from pink wax by ensuring approximal contact and a base was created. 14 different imaging protocols were used with 60 kVp, 4 mA 0.02-0.1 second and 70 kVp 7 mA, 0.25-1.25 second exposure parameters. Intact teeth were imaged with these various imaging protocols. Artificial cavities were then created for enamel caries, dentin caries and deep caries with exposed pulp and imaged according to the same protocols. The images were evaluated by 3 clinicians who were blind to the exposure protocol and caries status. Inter-observer agreement with actual situations was examined with Kappa statistics. Results: In the low-dose group, the kappa values of observer 1, observer 2, and observer 3 were 0.905, 0.952, 0.952, respectively. The kappa values of observer 1, observer 2, and observer 3 in the ultralow-dose group were 0.833, 1, 1, and the kappa values of observer 1, observer 2, and observer 3 in the high-dose group were 1, 1, 0.833, respectively. The results obtained in all groups showed a statistically significant-excellent agreement (p<0.001). Conclusion: Approximal caries can be diagnosed with intraoral radiography obtained with low radiation doses with PSP in dentistry. Thus, patients could be exposed to less ionizing radiation.

The radiographic evaluation of 11 different resin composites.

Radiopacities of dental materials used in restorations are very important in making the radiographic diagnosis. Therefore, the aim of our study was to evaluate the radiopacity of five single-shade and six simplishade resin composites with digital technique. Five different single-shade (Charisma Topaz One, Omnichroma, Clearfil Majesty ES-2 Universal, Vittra APS Unique, ZenChroma) and six different simplishade resin composites (G-aenial A'CHORD, Essentia Universal, OptiShade, Estelite Asteria, Filtek Universal, Filtek Z250) were used. For each group, five disk-shaped resin composites of 1mm and 2mm thicknesses were prepared. As a control, tooth slices with 1mm and 2mm thicknesses and a 99.5% pure aluminum step-wedge were used. The samples, tooth slices, and a step-wedge were placed on a photostimulable phosphor plate. Digital radiographs were taken from 30 and 40cm distances (70 kVp, 7mA 0.28ms). The images were analyzed using ImageJ software to measure the mean gray values. Data were analyzed using SPSS 22 package program and Kruskal-Wallis H Test (p < 0.05). The highest radiopacity was seen in Filtek Universal at both distances and thicknesses. Omnichroma had the lowest radiopacity in all parameters. All specimens showed higher radiopacity than dentin. Except for Omnichroma 1 and 2mm thick, Clearfil Majesty ES-2 Universal 2mm thick, samples showed higher radiopacities than enamel (p < 0.05). The restorative materials tested were found to be more radiopaque than dentin. The samples passed the International Organization for Standardization for radiopacity values. The radiopacity values were affected by thickness and type of materials.

Effect of 3 different disinfection methods on the image quality of photostimulable phosphor plates

The aim of this study was to assess the effects of 3 disinfection protocols on the quality of images acquired with a photostimulable phosphor (PSP) plate system. Thirty DIGORA Optime PSP plates were divided into 3 groups of 10. Group 1 was disinfected with 95% ethanol. Group 2 was disinfected using germicidal disposable wipes. Group 3 was disinfected with 95% ethanol, followed by hydrogen peroxide gas sterilization. Images of a quality assurance phantom were acquired on each plate before disinfection (baseline images). Disinfection and imaging cycles were repeated 45 times for each plate. Changes in image quality were assessed between baseline and final images. Image quality was evaluated for dynamic range, spatial resolution, and contrast perceptibility. The Fisher exact test was used to detect statistically significant differences among the 3 disinfection methods relative to decreases in image quality parameters between the baseline and final radiographs. Additionally, for each group, the Z-test was used to detect statistically significant decreases in image quality parameters between baseline and final images. The significance level was established at P < .05. No statistically significant differences were detected among the disinfection groups or relative to baseline values for any group at a 5% significance level. Hydrogen peroxide gas may be considered to prevent cross-contamination while preserving image quality. Regular quality assurance testing is recommended to maintain image quality over time.

Ambient light exposure of photostimulable phosphor plates: is there a safe limit for acceptable image quality?

To subjectively assess radiographs obtained with photostimulable phosphor (PSP) plates exposed to clinical levels of ambient light prior to read-out to potentially set a safe limit for acceptable image quality. Six dental regions of a dry human skull were X-rayed using PSP plates from VistaScan and Express under four exposure times: 0.1, 0.2, 0.32, and 0.4 s. Before read-out, the PSP plates were exposed to ambient light for 0, 5, 10, 30, 60, and 90 s. Six observers were asked to classify the 288 resulting radiographs as acceptable or unacceptable based on the identification of anatomical structures and global image quality. The number of answers classifying radiographs as unacceptable was used to calculate a rejection rate; a pairwise comparison for better image quality was further conducted among radiographs considered acceptable. Reproducibility was tested by having 25% of all experimental groups reassessed. Intra- and interobserver agreement ranged from 0.87 to 1.00 and from 0.81 to 0.92, respectively. Exposure of PSP plates to ambient light increased rejection rates mostly as of 10 s. In the pairwise comparison, subtle differences were observed between radiographs obtained with PSP plates not exposed and those exposed to ambient light for 5 s. Ambient light exposure of PSP plates impairs the image quality of radiographs. A safe limit of ambient light exposure of 5 s for VistaScan and Express should be considered. Ambient light exposure of PSP plates within safe limits can avoid retakes and reduce unnecessary patient exposure to X-rays.

The Effect of Different Image Processing Techniques on the Measurement Accuracy of Endodontics File Length.

Different software capabilities have been used in digital systems to increase the diagnostic quality of radiographic projections. Considering the availability of different enhancement techniques, it is necessary to determine the suitability of each technique for various diagnostic cases. There is controversy between studies over the effect of different digital enhancement techniques on the accuracy of file length measurements in endodontics. The present in vitro study aimed to determine the effect of the software capabilities on the diagnostic accuracy to determine endodontic file lengths in photostimulable phosphor (PSP) radiographs. In the present in vitro study, standard access cavities were prepared in 44 extracted human single-rooted permanent teeth. An endodontic file was placed in each root canal. PSP sensors were used for digital imaging using the parallel technique. All the images were reviewed on a same monitor; once normally with no software enhancement and once using software manipulations including pseudo-color, sharpness, emboss, and edge enhancement. The distance from the file tip to the rubber stop was measured on the images by an electronic ruler. Significantly, all of the image enhancement techniques presented shorter measurements comparing to the actual length. The results revealed the significant accuracy of the measured error in the pseudo-color enhancement technique compared to other techniques. The results revealed significant differences between the initial measurements (the gold standard) and those made on the manipulated radiographs. In all cases, the measurements were significantly lower than the real values. Therefore, none of these digital enhancement techniques can increase the accuracy of file length measurements significantly. However, manipulation with the pseudo-color option resulted in fewer errors compared to other options and the normal images. Hence, for precise measurements of the endodontic file lengths, pseudo-color processing algorithm can be suggested when using PSP sensors.

Disinfection of intraoral photostimulable phosphor plates with 70% ethyl alcohol and 70% isopropyl alcohol alters image contrast and produces image artifacts

This study evaluated changes in image quality and the presence and size of artifacts on radiographs obtained with photostimulable phosphor (PSP) plates after disinfection with 70% ethyl alcohol and 70% isopropyl alcohol. Eight PSP receptors (4 Express and 4 VistaScan) were used for the investigation. Two Express and 2 VistaScan receptors were disinfected with 70% ethyl alcohol, and 2 Express and 2 VistaScan receptors were disinfected with 70% isopropyl alcohol. Before disinfection and after every 5 disinfections, 2 radiographs of an aluminum stepwedge and 2 radiographs of an acrylic block were acquired using each receptor. The gray values of the radiographs were analyzed regarding contrast, density, uniformity, and noise. Four oral radiologists evaluated the images for the presence of artifacts, and 2 measured the artifacts. Differences in image contrast were significantly larger with isopropyl alcohol (P < .0001). Artifact size was significantly greater with the VistaScan system when isopropyl alcohol was used as the disinfectant (P < .0001). The correlation between the number of disinfections and artifact size was moderately positive with the Express system (P < .05) and strongly positive with the VistaScan system (P < .05) with both disinfectants. Small artifacts restricted to the edges of the image were observed with disinfection using both types of alcohol, and a positive correlation was found between artifact size and the number of disinfections. However, artifacts appeared earlier and of greater size with the VistaScan system when disinfected with 70% isopropyl alcohol. Thus, we recommend using 70% ethyl alcohol to disinfect PSP receptors, with attention placed on its action and evaporation times.

The effect of different spatial resolutions and enhancement filters on radiographic detection of simulated furcation defects with intraoral digital radiography

The objective of this study was to evaluate the effects of spatial resolution and the application of enhancement filters in the diagnosis of simulated furcation defects and image quality with intraoral radiographs. Periapical images were acquired with photostimulable phosphor plates of molars in dry skulls (n=8) and mandibles (n=10) with 4 stages of furcation defect simulation. The plates were scanned in fast scan and high resolution modes to produce different spatial resolutions. Four image filters were applied. Six observers scored the detection of furcation defects. Mean values of area under the curve in receiver operating characteristic evaluation, accuracy, sensitivity, and specificity were calculated. Mean gray value (brightness), noise, and contrast-to-noise ratio (CNR) were calculated for enamel, dentin, and alveolar bone to evaluate image quality. Analysis of variance compared the values between the different spatial resolutions and filters. The significance of difference was established at P < .05. There were no significant differences in overall diagnostic values comparing image spatial resolutions and filters. Diagnostic outcomes were significantly better for the largest defects than the smallest lesions but were generally poor in detecting lesions. All structures showed greater brightness in high resolution. . Noise was greater in all structures with all enhancement filters except inversion. Dentin and alveolar bone exhibited more noise and lower CNR in high resolution. Varying spatial resolution and applying enhancement filters did not significantly affect the diagnosis of furcation defects.

Evaluation of the Effect of Spatial Resolution on Image Quality in Phosphor Plate Systems

Purpose: This study aims to investigate the effect of 4 different scanning protocols offered by the VistaScan Mini Easy scanner on image quality at different exposure times. Materials &amp;amp; Methods: Four number size-2 photostimulable phosphor plates were exposed with 5 different exposure times while keeping other parameters constant. The exposed plates were scanned without delay using 4 different scanning protocols. 10 lp/mm, 20 lp/mm, 25 lp/mm, and 40 lp/mm are offered by the VistaScan Mini Easy scanner. The mean gray value was calculated using the ImageJ program by identifying three non-overlapping regions of interest from the background and each step in the obtained images. The mean of all mean gray values determined for the background and steps on a plate was also considered the mean gray value of that plate. Results: When plate mean gray values at 0.20 s and 0.40 s were examined, a statistically significant difference was observed between the scanning protocols (p&amp;lt;0.001, p=0.001 respectively). It was determined that the plate mean gray value at 40 lp/mm in 0.20 s was lower than that of other scanning protocols. The plate mean gray value at 20 lp/mm in 0.20 s was higher than that at 25 lp/mm. It was determined that the plate mean gray value at 10 lp/mm in 0.40 s was lower than that of the other groups. Conclusion: The effect of spatial resolution on diagnostics in digital imaging per se is a subject under investigation and still not agreed upon. Therefore, more studies on spatial resolution are needed.

Translucency and Radiopacity of Dental Resin Composites - Is There a Direct Relation?

The purpose of this study was to correlate the translucency degree of varying resin composites with their radiopacity. Twenty-four resin composites (conventional or bulk-fill) of various shades and opacities were selected from the following manufacturers: 3M ESPE (nanofilled), Ivoclar (nanohybrid), and FGM (microhybrid). Resin composite samples (n=5) were prepared (5-mm diameter × 1.5-mm thickness) for comparison using prepared samples of human dentin and enamel as controls. The translucency of each sample was measured using the translucent parameter (TP) method with a digital spectrophotometer (Vita Easyshade) and CIEL*a*b* color system over white and black backgrounds. The samples were also x-rayed using a photostimulable phosphor plate system for measurement of their radiopacity (in mmAl). All data were analyzed using one-way ANOVA and Student-Newman-Keuls (α=0.05); data for TP and radiopacity were correlated using the Spearman correlation test. Overall, the translucent shades and bulk-fill resin composites showed greater translucency than the other resins. While "body" and "enamel" shades demonstrated intermediate translucency to dentin and enamel, the "dentin" shades were more standardized, showing similar translucency to human dentin. All tested resin composites showed similar or greater radiopacity to human enamel, except the Empress Direct (Ivoclar) resin with Trans Opal shade, which was not radiopaque. Dentin and enamel showed radiopacity similar to 1 and 2 mmAl (millimeters of aluminum), respectively. The resin composites investigated in this study differed regarding their translucency degree and radiopacity level, without any positive relationship between the two properties.

Could the radiographic image quality be affected by the excessive use of the photostimulable phosphor plate?

The study aimed to assess the influence of excessive use of a photostimulable phosphor plate (PSP) on the density, image noise, and contrast of radiographs. For that, radiographs of an acrylic block were acquired with a PSP of the Express intraoral system to assess the density and image noise. Initially, five images were obtained and exported (first group). After 400 exposures to X-rays and scannings of PSP, other five images were obtained and exported (second group). The same procedure was done after 800 (third group), 1200 (fourth group), 1600 (fifth group), and 2000 acquisitions (sixth group), resulting in 30 images to be evaluated. The mean and standard deviation of the gray values were calculated for the images using the ImageJ software. For contrast analysis, radiographs of an aluminum step-wedge were acquired with a new PSP following the same acquisition intervals. The percentage of contrast variation was calculated. Another two unused PSP receptors were employed to evaluate the method's reproducibility. The comparison of the results among the acquisition groups was performed with one-way Analysis of Variance (α=0.05). Intraclass Correlation Coefficient (ICC) assessed the reproducibility of the receptors. Image noise did not differ among the groups (p>0.05). There was a slight increase in density after 400 acquisitions and a slight difference in contrast for all acquisition groups without a pattern of increase or decrease (p<0.05). ICC showed excellent reliability for the methods. Therefore, excessive PSP use slightly affected the radiograph's density and contrast.

Effects of Processing Delays in Different Coverages on the Image Quality of Photostimulable Phosphor Plates With Acteon and Digora Scanners

Background: Delay in the processing of photostimulable phosphor storage plates (PSP) is a common occurrence in crowded clinics. Accordingly, the effects of processing delays in different coverages on the image quality of photostimulable PSPs were investigated with Acteon and Digora scanners. Methods: Three Acteon (group A) and three Digora (group B) PSPs were used in this in vitro study. Each group had three subgroups according to three coverages, including protective box (A1 , B1 ), semitransparent (A2 , B2 ), and original dark case plates (A3 , B3 ). An aluminum step wedge was subjected to constant exposure conditions. The exposed plates were immediately processed with their corresponding scanner device (the golden standard), 5, 10, 20, 30, 40, and 60 minutes after exposure. The average gray level information of the 2nd, 5th, and 8th steps of the Al wedge was considered as the mean gray values (MGVs) of each wedge. The difference between the gray values of the 8th and 2nd steps was measured as image contrast. Results: There was a significant difference between the contrast and MGVs of Acteon and Digora PSPs at all processing delay times (P&lt;0.05). In general, there was no significant difference in the image MGVs and contrast between subgroups in any of the scanners (total P&gt;0.05). In each subgroup, MGVs increased, while contrast decreased by increasing the processing delay time; the difference was significant except for the MGVs in the first 5 minutes of A1 (P=0.12) and A3 (P=0.06). Conclusions: Thus, the type of scanner was effective on image quality; the type of PSP coating in the first few minutes could affect the rate of image quality loss. However, the scan time had a greater effect on the amount of image loss.

Accuracy of Three Types of Apex Locators versus Digital Periapical Radiography for Working Length Determination in Maxillary Premolars: An In Vitro Study.

This study aimed to compare the accuracy of three types of apex locators versus digital radiography for working length (WL) determination. This experimental study was conducted on 58 extracted maxillary premolars. The teeth were decoronated, the access cavity was prepared, and WL was determined using a #15 K-file to serve as reference. The WL was then measured by Woodpex V, Woodpex III, and Root ZX apex locators in the presence of 0.9% saline, and also on a photostimulable phosphor plate (PSP) digital radiograph taken by the parallel technique. The values were compared with the actual WL using the paired t-test (alpha = 0.05). Digital radiography, Root ZX, Woodpex V, and Woodpex III determined the WL within ±0.5 mm from the actual value in 84.48%, 100%, 89.66%, and 87.93% of the cases, respectively. Woodpex V (p = 0.039), Woodpex III (p = 0.001), and Root ZX (p = 0.001) significantly over-estimated the WL. The WL measured on digital radiographs was not significantly different from the actual WL (p = 0.213). The position of the apical foramen (central/lateral) had no significant effect on the accuracy of WL determination by different techniques (p >0.05). Within the limitations of this in vitro study, all the tested modalities showed acceptable accuracy for WL determination in maxillary premolars.

Influence of extensive use of a photostimulable phosphor receptor on the diagnosis of proximal carious lesions: An in vitro study

The aim of this study was to evaluate the influence of the extensive use of a photostimulable phosphor (PSP) receptor on the diagnosis of proximal carious lesions. Forty posterior teeth were paired and mounted in 20 phantoms. Using a PSP receptor of the Express intraoral system, 1 radiograph of each phantom was acquired, totaling 20 radiographs (group 1). After 400 acquisitions, another radiograph of each phantom was obtained, totaling 20 new radiographs (group 2). This procedure was also done after 800 (group 3), 1,200 (group 4), and 1,600 (group 5) acquisitions, resulting in 100 radiographs. Another 40 radiographs (20 phantoms×2 groups) were obtained with a second PSP sensor to evaluate the diagnostic replicability of the receptors. All 140 radiographs were assessed independently by 5 examiners for the presence of proximal caries. Area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared among the groups by analysis of variance. The Student t test evaluated the diagnostic replicability of the receptors. The significance level was set at 5% (P < .05). The diagnostic outcomes for proximal caries did not differ among the groups (P ≥ .37). The diagnostic values did not differ among the radiographs acquired with the 2 PSP receptors (P ≥ .75). The diagnosis of proximal carious lesions was not affected by extensive use of the PSP receptor.

Relationship between image information content and observer performance in digital intraoral radiography.

This study conducted a receiver operating characteristic (ROC) analysis by applying improved cluster signal-to-noise (CSN) analysis to digital intraoral radiographs and develop an observer-free method of analyzing image quality related to the observer performance in the detection task. Two aluminum step phantoms with a thickness interval of 1.0mm were used for this study. One phantom had holes of increasing depth (from 0.05 to 0.35mm) and the other had no holes. Phantom images were obtained under various exposure dose and image capture modes using a dental X-ray unit, a photostimulable phosphor imaging plate, and scanner system. These phantom images were analyzed using the FindFoci plugin in ImageJ software. Subsequently, true positive rates (TPRs) and false positive rates (FPRs) were calculated by analyzing phantom images with and without holes. We constructed ROC curves by plotting the TPRs against the FPRs and calculated the area under the ROC curve (AUC). Using the same phantom images with holes, eight observers assessed the number of detectable holes. Correlations between observer detection performance and AUC values were evaluated. AUC values increased as the exposure dose increased and showed different tendencies depending on the image capture mode. The AUC values showed a high correlation with observer detection performance (r = 0.76). AUC values obtained from CSN analysis reflect image quality and replace the observer detection performance test of image quality.