Image Quality Comparison between 10kVp Technique and 15 Percent Rule on AP Supine Abdominal X-ray Examination

The abdomen is one of the thickest parts of the human body and there are challenges in obtaining good images due to the thickness and pathology of the patient during an abdominal X-ray. The 15% rule and the 10 kVp technique are used as exposure manipulation methods in abdominal radiography, however, theoretically, the 15% rule is preferred. The 15% rule provides optimal exposure while the 10 kVp technique is simpler in terms of calculating the exposure factor. These two techniques have their advantages; therefore, this study aims to compare the image quality between the 15% rule and the 10 kVp technique of X-ray supine anteroposterior (AP) abdominal radiography image quality and evaluate whether 10 kVp could be an exposure replacement technique for the 15% rule. Five abdomen radiographic images were taken based on both techniques and evaluated quantitatively using ImageJ software and qualitatively based on scoring by two radiographers. Based on the result of the experimental study, the SNR (signal-to-noise) ratio, CNR (contrast-to-noise ratio) and image mean score had no significant differences (p-value>0.05) between the 10 kVp and 15% rule. In conclusion, the 10 kVp technique is a possible substitution for the 15% rule in obtaining valuable diagnostic image quality during AP abdominal X-ray projection and is more suitable to be implied in clinical settings compared to the 15% rule.