Radiographic Image Quality Research Articles

Investigation of Extraoral Dental Radiography Examination Rejections at a Dental and Oral Hospital in Semarang, Indonesia

Background : Extraoral radiography techniques, such as panoramic radiography and cephalometric radiography, are used to obtain an overall view of the teeth, jaws, and surrounding tissues. However, there are instances where radiographic images are rejected or marked as inadequate based on the required quality standards. Reject analysis is a method of evaluation that involves analyzing rejected dental radiographic images. This research will identify the most common factors contributing to image rejection and provide recommendations for improving the quality of dental radiographic images Methode : The type of scientific study in this research is quantitative and descriptive. The research was conducted at the Radiodiagnostic Department of the Dental Hospital, Muhammadiyah University of Semarang. The total sample size taken was 301 extraoral radiographic films. The research data were obtained through a retrospective survey approach and observation method. The analysis was performed using Microsoft Excel 2021 application. Result : The primary factors contributing to film rejection are patient movement (50%), patient positioning (25%), and device settings (25%). Film rejection for extraoral radiographic examinations consisted of 2 films in Panoramic examinations, accounting for 50%, and 2 films in Cephalometric examinations, also accounting for 50% Conclusion : The film rejection ratio for extraoral dental radiography examinations conducted at the Radiodiagnostic Department of the Dental Hospital, Universitas Muhammadiyah Semarang, remained below the normal limit value of 1.29%.

IMPROVING BITEWING RADIOGRAPHY: EVALUATING THE EFFECT OF A DENTAL X-RAY POSITIONER ON IMAGE QUALITY IN DENTAL EXAMINATIONS

Bitewing radiography is a valuable tool in detecting and monitoring dental decay and other oral health problems and is typically performed as part of a routine dental examination. It has certain limitations that should be considered. Some of these limitations may cause discomfort or pain to the patient if not positioned correctly. Some patients may find biting down on the film holder difficult or have a strong gag reflex, making the procedure uncomfortable or even impossible. Bitewing radiography can be costly, especially if it needs to be performed regularly, which may limit access to this diagnostic tool for some patients. This study aimed to evaluate the effect of a dental X-ray positioner with a silicone layer on the quality of radiographic images in posterior bitewing dental examinations. Using this positioner was expected to improve the precision of radiographic interpretation and subsequent patient treatment. The study used a multivariate general linear model to analyze the data obtained from radiographic images using the X-ray positioner with the silicone layer and the conventional X-ray positioner. The results showed no significant difference in image quality between the two positioners, indicating that adding the silicone layer did not significantly improve image quality. However, using any X-ray positioner is still beneficial in ensuring accurate radiographic interpretation and subsequent patient treatment.

Analysis of the Neutron Radiographic Image Quality and Beam Intensity Produced by a Compact Multichannel Collimator

We investigate the image quality and beam intensity of thermal neutron radiography after replacing a standard single-channel neutron collimator with a compact array of microcollimators. In this study, the MCNP6 Monte Carlo computer code was used to simulate a 2 × 2-cm-area isotropic thermal neutron source, which then was collimated by an array of micron-sized neutron collimators that measured 29.8 μm in diameter and with lengths that varied from 0.6 to 3 mm. These microcollimators were spaced 30 μm apart and assembled into a 2 × 2-cm array. The image quality of the neutron beams produced by the resulting collimator arrays was assessed by imaging the edge of a very thin (~0.01-mm) gadolinium foil to obtain the image Modulation Transfer Function (MTF). The MCNP6 resulting flux map from each simulation then was converted into a grayscale .tiff image and the image’s resulting MTF obtained using the ImageJ computer program with the imaging beam geometric unsharpness, which is a limiting factor in the image resolution determined at the 10% value of the MTF curve. In this study, we found that a 2 × 2× 0.298-cm microcollimator, corresponding to a length-to–hole diameter ratio of 100:1 and a collimator length of 2.98 mm produced a beam with a geometric unsharpness of 32 μm. Compared to a standard single-channel collimator with a 2 × 2-cm aperture, the single-channel collimator would need to be 660 cm long to produce an equivalent geometric sharpness. Yet because of its shorter length, the imaging beam intensity from our 2.98-mm-thick collimator array was approximately 50 times greater than that of an equivalent single-channel collimator.

Radiation Dose Reduction in Different Digital Radiography Systems: Impact on Assessment of Defined Bony Structures in Bearded Dragons (Pogona vitticeps).

Three different digital detector systems were used to study the effect of a defined radiation dose reduction on the image quality of digital radiographs in bearded dragons (Pogona vitticeps). A series of radiographs of seven bearded-dragon cadavers with a body mass ranging from 132 g to 499 g were taken in dorsoventral projection. The digital systems employed included two computed radiography systems (CR) (one system with a needle-based and one with a powdered-based scintillator) and one direct radiography system (DR). Three levels of the detector dose were selected: A standard dose (defined based on the recommended exposure value of the CRP, D/100%), a half dose (D/50%), and a quarter dose (D/25%). Four image criteria and one overall assessment were defined for each of four anatomic skeletal regions (femur, rib, vertebra, and phalanx) and evaluated blinded by four veterinarians using a predefined scoring system. The results were assessed for differences between reviewers (interobserver variability), radiography systems, and dosage settings (intersystem variability). The comparison of the ratings was based on visual grading characteristic (VGC) analysis. Dose reduction led to significantly lower scores in all criteria by every reviewer, indicating a linear impairment of image quality in different skeletal structures in bearded dragons. Scores did not differ significantly between the different systems used, indicating no advantage in using a computed or direct radiography system to evaluate skeletal structures in bearded dragons. The correlation was significant (p ≤ 0.05) for interobserver variability in 100% of the cases, with correlation coefficients between 0.50 and 0.59. While demonstrating the efficacy of the use of digital radiography in bearded dragons and the similar quality in using different computed or direct radiography systems, this study also highlights the importance of the appropriate level of detector dose and demonstrates the limits of post-processing algorithm to compensate for insufficient radiation doses in bearded dragons.

Deep Learning Neural Network Performance on NDT Digital X-ray Radiography Images: Analyzing the Impact of Image Quality Parameters-An Experimental Study.

In response to the growing inspection demand exerted by process automation in component manufacturing, non-destructive testing (NDT) continues to explore automated approaches that utilize deep-learning algorithms for defect identification, including within digital X-ray radiography images. This necessitates a thorough understanding of the implication of image quality parameters on the performance of these deep-learning models. This study investigated the influence of two image-quality parameters, namely signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), on the performance of a U-net deep-learning semantic segmentation model. Input images were acquired with varying combinations of exposure factors, such as kilovoltage, milli-ampere, and exposure time, which altered the resultant radiographic image quality. The data were sorted into five different datasets according to their measured SNR and CNR values. The deep-learning model was trained five distinct times, utilizing a unique dataset for each training session. Training the model with high CNR values yielded an intersection-over-union (IoU) metric of 0.9594 on test data of the same category but dropped to 0.5875 when tested on lower CNR test data. The result of this study emphasizes the importance of achieving a balance in training dataset according to the investigated quality parameters in order to enhance the performance of deep-learning segmentation models for NDT digital X-ray radiography applications.

Radiographers' decision-making processes in the movement of pain-afflicted adult trauma patients in planar diagnostic imaging.

The need to balance pain management and radiographic image quality is at the forefront of patient care in diagnostic radiography. This study aimed to identify the decision-making that radiographers employ when undertaking planar diagnostic imaging for pain-afflicted adult trauma patients and the factors that influence these decisions. A virtual focus group interview was undertaken with six experienced Australian radiographers using a realistic scenario and questions based on it. Thematic analysis was employed to explore how radiographers approached planar diagnostic imaging of trauma patients and what influenced decisions regarding patient movement. Five key factors in radiographers' decision-making were identified: assistance from the multidisciplinary team, understanding the patient, pain reduction methods, the patient being informed and radiographer competence. Radiographers were found to further utilise professional knowledge of image interpretation and anatomy and physiology, in conjunction with interpersonal capabilities, to undertake radiographic examinations. The decision-making process that informs the movement of pain-afflicted adult trauma patients is multifactorial, aligning with the broad healthcare principles of multidisciplinary teamwork, holistic management of the patient and professional knowledge and practice. Further research is needed to explore correlations with different patient groups to validate this research.

Implementasi Pemeriksaan Lumbosacral pada Kasus Scoliosis di Instalasi Radiologi BLUD Rumah Sakit Umum Daerah Cut Nyak Dhien Meulaboh

The aim of this study was to find out how the implementation of the lumbosacral examination in cases of Scoliosis and how to describe the quality of radiographic images on lumbosacral examination using Anterior Posterior (AP) Projection, Lateral Projection, and Anterior Posterior Projection bending left and right in terms of detail and sharpness. This study was conducted with three exposures to one patient who was diagnosed with lumbosacral scoliosis using the same distance but with different projections. The results of this study are in the form of lumbosacral radiographs and distribution frequency tables of ten radiographer respondents. The results showed that the lumbosacral examination in cases of scoliosis at the Radiology Installation BLUD, Cut Nyak Dhien Hospital, Meulaboh, West Aceh can use three different projections, namely anterior posterior projection, lateral projection and anterior posterior bending left right projection. The quality of the lumbosacral radiograph images produced in cases of scoliosis is clear and good in detail and has a sharpness level from the distance, patient movement, and the use of the viewing box.

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.

Image feature index: A novel metric for quantifying chest radiographic image quality.

Radiographic X-ray imaging is a common clinical examination. Current objective methods for quantifying image quality for radiographs struggle to capture the combined impact of factors throughout the imaging chain on the perceived image quality. Therefore, there is a need to further develop metrics that correlate with image quality as perceived by the observer. We proposed the image feature index (IFI) to comprehensively quantify radiographic X-ray image quality. We also aimed to study the correlation between IFI and observer-perceived image quality for chest radiographs. The IFI algorithm was developed, which measured the amount of information, textural features, and noise in the image. A total of 70 chest phantom radiographs were generated under 60-120kV and 0.2-80mAs. A vendor-proprietary exposure index (EI) and dose area product (DAP) were extracted from the DICOM header in addition to calculating IFI for each image to investigate the relationships between IFI, EI and DAP. The quality of the images was rated by three observers, and the correlation between IFI and subjective score of image quality was tested. Next, a retrospective study using a random sample of 50 clinical chest radiographs was performed, and the correlation between IFI and subjective score was tested. The correlation was determined by the Spearman test. The curves of IFI versus DAP and IFI versus EI both demonstrated a similar three-stage form where IFI is above zero: in the first stage, IFI increases rapidly with increased DAP or EI, whereas in the second stage, the slope of the curves decreased towards an asymptote, that is, minimal gain in IFI with increased DAP or EI-until they hit the inflection point and then descended sharply in the third stage. For both phantom and clinical chest images, IFI demonstrated good correlation with subjective score (r=0.9084 for phantom images, r=0.8153 for clinical images). IFI is a feasible and efficient descriptor for image quality for chest radiographs. Future studies with larger sample sizes and sample types are needed to confirm the feasibility of IFI for other exam types and anatomical views, thus fulfilling and extending the potential applications of IFI in quality control and radiation dose reduction.

Perceptual and objective physical quality of chest images: a comparison between digital radiographic chest images processed for cancer screening and pneumoconiosis screening in Japan.

This study (1) evaluated the perceptual and objective physical quality of digital radiographic chest images processed for different purposes (routine hospital use, lung cancer screening, and pneumoconiosis screening), and (2) quantified objectively the quality of chest images visually graded by the Japan National Federation of Industrial Health Organization (ZENEIREN). Four observers rated the images using a visual grading score (VGS) according to ZENEIREN's quality criteria. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Between groups, differences were assessed using ANOVA (followed by Bonferroni multiple comparisons) or unpaired t-test. The Pearson's correlation coefficients were calculated for the correlation between perceptual quality and objective physical image quality. The image quality perceived by the observers and the SNR measurements were highest for the images generated using parameters recommended for lung cancer screening. The images processed for pneumoconiosis screening were rated poorest by the observers and showed the lowest objective physical quality measurements. The chest images rated high quality by ZENEIREN generally showed a higher objective physical image quality. The SNR correlated well with VGS, but CNR did not. Highly significant differences between the processing parameters indicate that image processing strongly influences the perceptual quality of digital radiographic chest images.

Effect of Tube Voltage (kV) on Radiographic Image Quality of TOR-CDR Phantom Object

The test object was selected in the form of a TOR-CDR phantom which was exposed to X-rays with a low tube voltage (kV) and adjusted the contrast enhancement in the radiographic image. The study of this method was carried out by varying the tube voltage (kV) from 60 kV-80 kV and increasing contrast from 5%-30%. Based on the tests carried out, increasing the tube voltage (kV) can improve image quality, but increase the radiation dose received. However, giving enhancement can reduce tube voltage (kV) and improve image quality. The decrease in the average pixel value against the contrast on the TOR-CDR phantom follows the second order of polynomial equations, y=Ax2+Bx+. The coefficient A, B and C has linear relationship with the tube voltage (kV). The coefficient A has a decreasing trend and the coefficient B has an increasing tendency as the tube voltage (kV) increase. Meanwhile, the coefficient C shows the noise level in the image. Contrast enhancement can reduce the tube voltage (kV) used, but this contrast increase can only be done in a limited way. In this research, the maximum contrast enhancement limit in the image is 10% with 12-13 visible circles from 17 circles on the object.

Application of Two-Dimensional Entropy Measures to Detect the Radiographic Signs of Tooth Resorption and Hypercementosis in an Equine Model.

Dental disorders are a serious health problem in equine medicine, their early recognition benefits the long-term general health of the horse. Most of the initial signs of Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) syndrome concern the alveolar aspect of the teeth, thus, the need for early recognition radiographic imaging. This study is aimed to evaluate the applicability of entropy measures to quantify the radiological signs of tooth resorption and hypercementosis as well as to enhance radiographic image quality in order to facilitate the identification of the signs of EOTRH syndrome. A detailed examination of the oral cavity was performed in eighty horses. Each evaluated incisor tooth was assigned to one of four grade-related EOTRH groups (0-3). Radiographs of the incisor teeth were taken and digitally processed. For each radiograph, two-dimensional sample (SampEn2D), fuzzy (FuzzEn2D), permutation (PermEn2D), dispersion (DispEn2D), and distribution (DistEn2D) entropies were measured after image filtering was performed using Normalize, Median, and LaplacianSharpening filters. Moreover, the similarities between entropy measures and selected Gray-Level Co-occurrence Matrix (GLCM) texture features were investigated. Among the 15 returned measures, DistEn2D was EOTRH grade-related. Moreover, DistEn2D extracted after Normalize filtering was the most informative. The EOTRH grade-related similarity between DistEn2D and Difference Entropy (GLCM) confirms the higher irregularity and complexity of incisor teeth radiographs in advanced EOTRH syndrome, demonstrating the greatest sensitivity (0.50) and specificity (0.95) of EOTRH 3 group detection. An application of DistEn2D to Normalize filtered incisor teeth radiographs enables the identification of the radiological signs of advanced EOTRH with higher accuracy than the previously used entropy-related GLCM texture features.

How Does Ambient Light Affect the Image Quality of Phosphor Plate Digital Radiography? A Quantitative Analysis Using Contemporary Digital Radiographic Systems.

The aim of this study is to quantitatively evaluate the influence of the duration of ambient light exposure on the image quality of digital radiographs obtained with contemporary phosphor plate (PSP)-based systems. Radiographs of an aluminum step-wedge were obtained using VistaScan and Express systems at five X-ray exposure times: 0.10, 0.20, 0.32, 0.40, and 0.50 s; the resulting dose-area products were, respectively, 21.93, 43.87, 70.19, 87.75, and 109.6 mGycm2. Before PSP read-out, half of the sensitive surface of the PSP plates was exposed to ambient light for 5, 10, 30, 60, and 90 s. The effect of light exposure on brightness, contrast, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and image saturation was compared using ANOVA with the Tukey test (α = 0.05). Ambient light exposure increased brightness and contrast and reduced CNR and SNR in PSP-based radiographs of contemporary digital systems. At the longest X-ray exposure times, ambient light exposure reduced the dark saturation (mean gray values ≤ 1) observed in Express. In conclusion, the negative effects of ambient light observed on the image quality of PSP-based radiographs are directly proportional to the duration of exposure. Clinicians should be aware of such harmful effects when handling and scanning PSP plates in bright environments.

Digital radiography image quality evaluation using various phantoms and software.

To investigate the effect of the exposure parameters on image quality (IQ) metrics of phantom images, obtained automatically using software or from visual evaluation. Three commercial phantoms and a homemade phantom constructed according to the instructions given in the IAEA Human Health Series No. 39 publication were used, along with the respective software that estimate automatically various IQ metrics. Images with various exposure parameters were acquired in a digital radiography (DR) unit. For the commercial phantoms, visual evaluations were also performed. The IQ scores obtained were analyzed to investigate the effects of increasing incident air kerma (IAK), tube potential (kVp), additional filtration, and acquisition protocol on IQ. The effects of the exposure parameters on the IQ metrics, determined with the commercial and the IAEA phantoms, were not the same. For example, clear trends of improvement of IQ scores with increased IAK and reduction of most IQ scores with increased kVp were observed mostly with the IAEA phantom, but not with the commercial phantoms (for both automatic and visual scoring methods). For all phantoms, the maximum variations in IQ scores observed for repeated identical exposures were almost always below 10% with automatic evaluation whereas, for visual evaluation, reached 17%. Failure to detect some expected trends with the complex commercial phantoms may be attributed to the fact that IQ in DR is more strongly affected by the post-processing procedures, which may mask the effect of other parameters on IQ, something that was not observed with the simple IAEA phantom.

The Effect of Different Field of View Sizes on Contrast-to-Noise Ratio of Cone-Beam Computed Tomography Units: An In-Vitro Study.

Objectives: 'Field of view (FOV) size' affects the quality of radiographic images and the radiation dose received by patients. In cone-beam computed tomography (CBCT) FOV should be selected according to therapeutic purposes. While aiming for the highest diagnostic image quality, the radiation dose should be kept to a minimum to reduce the risk for patients. The purpose of this study was to assess the effect of different sizes of FOV on contrast-to-noise ratio (CNR) in five different CBCT units. Materials and Methods: In this experimental study, CBCT scans were taken from a dried human mandible containing a resin block fixed to the lingual cortex and a resin ring was used to simulate soft tissue during scans. Five CBCT units including, NewTom VGi, NewTom GiANO, Soredex SCANORA 3D, Planmeca ProMax, and Asahi Alphard 3030 were evaluated. Each unit had 3 to 5 different FOVs. Images were obtained and analyzed with ImageJ software and CNR was calculated in each image. ANOVA and T-test were used for statistical analysis (P<0.05). Results: Comparison among different FOVs of each unit showed significant CNR reductions in small FOVs (P<0.05). Similar FOV sizes of different CBCT devices were also compared and demonstrated significant differences (P<0.05). Conclusion: A direct relationship between FOV size and CNR was observed in all five CBCT units, but differences in exposure parameters of these units led to variable CNR in FOVs with similar sizes.

Evaluation of histogram equalization and contrast limited adaptive histogram equalization effect on image quality and fractal dimensions of digital periapical radiographs.

This study aims to evaluate the effects of histogram equalization (HE) and contrast limited adaptive histogram equalization (CLAHE) on periapical images and fractal dimensions in the periapical region. In this cross-sectional study, digital periapical images were selected from the archive of Dentistry School of Isfahan University of Medical Sciences. The radiographs were taken from mandibular and maxillary anterior single root teeth with healthy root and periodontium. After applying HE and CLAHE algorithms to images, two radiologists evaluated the quality of apex detection from using a 5-point Likert scale (from 5 for very good image quality to 1 for very bad image quality). Afterward, all the images were imported to the ImageJ application, and the region of interest (ROI) was specified as the region between the two central incisors. The fractal box-counting method was used to determine fractal dimensions (FD) values. Nonparametric Wilcoxon-Friedman test, Intraclass Correlation Coefficient test, T-test, and Pair T-test were performed as statistical analysis (α = 0.05). Fifty-three radiographs were analyzed and the image quality assessments were significantly different between raw images and images after performing HE, CLAHE (p value < 0.001), and using CLAHE algorithm significantly increases image quality assessments more than HE (p value = 0.009). There was a significant difference in FD values for images after applying CLAHE and HE compared to raw images (p value < 0.001), and HE decreased the FD value significantly more than CLAHE (p value = 0.019). Employing CLAHE and HE algorithm via OpenCV python library improves the periapical image quality, which is more significant using the CLAHE algorithm. Moreover, applying CLAHE and HE reduces trabecular bone structure detection and FD values in periapical images, especially in HE.

An Assessment of Image Quality of Radiographs in a Nigerian Teaching Hospital by Film Densitometry

3000 radiographs covering chest, upper limb, lower limb,lumbar spine (AP) and skull (PA) from the University ofCalabar teaching hospital (UCTH) were retrospectivelystudied by densitometry to assess the degree of variationin radiographic contrast over a ten year period (1999 –2008). The results show that variation in meanradiographic contrast from year to year was statisticallyinsignificant (p &lt; 0.05) for the respective projectionsstudied. This result implies a relatively basicstandardisation in image quality arising from consistencyin technique acquired over time. The results would serveas a baseline for developing a more robust qualityassurance programme in the hospital.

Long cone versus short cone for digital intraoral radiographic imaging

<h3>Background</h3> Intraoral radiographs are acquired by one of two methods: the long cone paralleling technique that uses a 30 cm distance from the focal spot to the end of the beam indicating device (BID) versus the short cone technique of 20 cm. The long cone paralleling technique (LCPT) reduces x-ray beam divergence, scatter radiation, penumbra, and magnification as well as entrance skin exposure. LCPT has been recommended for use with digital intraoral radiographic imaging. However, most intraoral generators are supplied with only a short cone BID. <h3>Objective</h3> This research project evaluated image quality of digital radiographs acquired with both long cone and short cone techniques. <h3>Study Design</h3> A series of incrementally increasing exposures of a digital intraoral quality assurance phantom was acquired with both long and short cone methods over a range of exposures from 10 ms to 800 ms to encompass all exposures in the clinical range. Image quality was evaluated using a scientifically validated method that has been published in other research studies on digital intraoral image quality. The image quality parameters assessed were dynamic range, contrast perceptibility, and spatial resolution as specified in ANSI /ADA Standard No. 1094 Quality Assurance for Digital Intra-oral Radiographic Systems. Images were visually evaluated and then objectively evaluated using the NIH ImageJ software for validation. <h3>Results</h3> The results support the use of the LCPT for the acquisition of digital intraoral radiographic images. <h3>Conclusion</h3> The additional purchase of the BID extension is substantiated by the results. <b>Statement of Ethical Review</b> Ethical Review or exemption was not warranted for this study

Applying ADA/ANSI Standard 1094: Impact of image adjustments and display device on subjective assessments

<h3>Objective</h3> To examine operator and device factors that impact subjective assessment of digital radiographic image quality. <h3>Study design</h3> The DDQA phantom was used to generate images to assess spatial resolution, contrast perceptibility, and latitude. The phantom was imaged using an XDR size 2 sensor with a Gendex Expert DC intraoral x-ray source (65 kVp, 7.5mA) at 8 exposure times. Five observers analyzed the images in the native XDR software. Observers were allowed to adjust brightness and contrast to facilitate visualization. Images were analyzed in two environments: a diagnostic radiology reading room with lowered ambient lighting and a Dell Ultrasharp monitor, and an intraoral radiographic room with bright ambient light (450 lux) and an HP EliteOne Computer. The optimum exposure, defined as the lowest exposure that provided the highest feature visualization, was recorded. <h3>Results</h3> In the radiology reading environment, observers were able to discern the full latitude of grayscales at all exposure times. The mean optimal exposure was 0.25s for discerning contrast wells and 0.32s for discerning spatial resolution. Scoring the same images in the intraoral radiography room environment yielded identical results. All observers were able to discern the full image latitude, and the identified optimal exposures were unchanged (0.25s for contrast wells and 0.32s for spatial resolution). <h3>Conclusions</h3> We demonstrate that establishing optimal exposure using the DDQA phantom is reliable, with minimal individual variation. Image adjustments cannot compensate for decreased information. Interestingly, room lighting conditions and display device did not change observer assessments of image quality and optimal exposure times when the observers were allowed to manually adjust brightness and contrast of the presented image. This further validates image quality-guided approaches to establish optimal exposure times in dental clinic settings. In ongoing studies, we will study different display models and ambient lighting settings that are more typical of chair-side settings. <b>Statement of Ethical Review</b> Ethical Review or exemption was not warranted for this study

Age estimation by Drusini's method and Jeon's method in Indian population - A comparative assessment.

There has been extensive focus on forensic odontology with an increase in the research for age estimation procedures. Teeth are biological markers for human age estimation. In adults, age estimation with a tooth has to be done by the analysis of cementum annulations, root transparency and determination of aspartic acid racemization. Various age estimation methods are known in literature; however, the reliability and relevance of these methods for the Indian population have seldom been studied. To assess and compare age estimation by Drusini's method and Jeon's method and correlate chronological age and age estimation by both the methods in Indian Adults. Comparative assessment of Drusini's method and Jeon's method for age estimation within Indian adults. Two hundred intraoral periapical radiovisuographs of the patients aged 20-69 years with optimum diagnostic quality radiographic images of permanent mandibular first molars were selected from the digital archive of the Department of Oral Medicine Diagnosis and Radiology from the dental college. Measurements were done using Drusini's and Jeon's methods and compared with the chronological age. A P < 0.05 was considered statistically significant. Analysis of variance followed by Tukey's Post hoc test, t-test. Mean chronological age, estimated using Jeon's method and estimated by Drusini's method, was 30.77 ± 9.32, 29.790 ± 7.729 and 27.885 ± 8.190, respectively. This difference was statistically highly significant, whereas Jeon's method showed a strong positive correlation between chronological age and age. The study concludes that Jeon's method is more accurate than Drusini's in the Indian population.