Background: The lightweight mobile radiography systems allow for almost hand-held radiography, potentially enhancing the accessibility of diagnostic imaging outside the hospital. While such mobile X-ray systems are easy to handle, they must still provide high image quality to ensure accurate diagnosis. The aim of this study was to optimize the use of mobile radiography equipment by investigating exposure parameters to ensure high image quality, comparing image quality with stationary radiography equipment, and evaluating the potential for dose reduction without compromising image quality.

Methods: Thirty-six images of the chest, pelvis and hip (26 mobile; 10 stationary) on a whole-body phantom were acquired with different exposure parameters. The images were evaluated by six observers. Subjective image quality was scored on a 5-point ordinal scale. The data were analyzed via visual grading characteristics analysis. The dose was measured by the dose-area product (DAP).

Results: The optimal tube voltages for the mobile radiography equipment were 70 kVp (small-sized phantom) and 90 kVp (medium-sized phantom) for pelvis AP images, 80kVp for hip AP, and 90kVp for hip cross-table lateral images. The mobile radiography equipment showed significantly better image quality than the stationary equipment for pelvis AP (small-sized phantom), hip AP and hip cross-table lateral as well as for chest AP and for lateral images (medium-sized phantom) with AUCVGA values ranging from 0.68 to 0.95. For chest images acquired with reduced tube load, no significant difference in image quality was found between the mobile and stationary radiography equipment for chest AP images and chest lateral images for the medium-sized phantom. Stationary radiography equipment showed better image quality for small phantom size. The DAP values were lower for the mobile system than for the stationary system.

Conclusions: The image quality for the lightweight radiographic equipment was at least as good as that of a stationary system at a lower radiation dose. Reduced tube load allowed for dose reduction by approximately 35% for chest AP images.