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Determination of Cardiothoracic Ratio (CTR) and Image Contrast in Chest Radiographs Using Variations in Focus-Film Distance (FFD) Fickry Haikal; Sri Dewi Astuty; Sultan Hamjar; Syamsir Dewang; Bannu Bannu; Arfinna Arfinna; Ayu Hardianti Pratiwi; Ajeng Anggreny Ibrahim
BULETIN FISIKA Vol. 27 No. 2 (2026): BULETIN FISIKA
Publisher : Departement of Physics Faculty of Mathematics and Natural Sciences, and Institute of Research and Community Services Udayana University, Kampus Bukit Jimbaran Badung Bali

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/BF.2026.v27.i02.p13

Abstract

Posteroanterior (PA) chest radiography is generally recommended at a focus-to-film distance (FFD) of 180 cm to minimize magnification of the cardiac silhouette, which may affect assessment of cardiomegaly. However, shorter FFDs are sometimes unavoidable because of room constraints or patient-related conditions. This study aimed to evaluate cardiothoracic ratio (CTR) values obtained at different FFDs and assess cardiac image quality using the contrast-to-noise ratio (CNR) to determine the visibility of the right and left cardiac borders. A descriptive observational study with a post-test-only design was conducted using 70 digital PA chest radiographs from male patients aged 17–22 years. The images were divided into seven FFD groups ranging from 120 to 180 cm, with 10 independent samples per group. CTR and CNR were quantitatively measured using ImageJ software. All radiographs demonstrated CTR values below 50% across the investigated FFDs, indicating no radiographic evidence of cardiomegaly. The highest mean CNR values were observed at FFDs of 140 cm (64.458), 150 cm (58.639), and 180 cm (50.758). Statistical analysis revealed no significant differences in CTR (p = 0.515) or CNR (p = 0.141) among the FFD groups. The observed fluctuations in CTR and CNR were likely attributable to inter-individual anatomical variation rather than FFD-related magnification. Differences in chest geometry and tissue attenuation, particularly variations in thoracic thickness and density, may have contributed substantially to the observed measurements. These findings suggest that, within the investigated range, FFD variations from 120 to 180 cm did not significantly affect CTR or CNR in young adult male subjects.
PENGARUH LUAS KOLIMASI DAN KETEBALAN PHANTOM ANSI TERHADAP NILAI EXPOSURE INDEX DAN DOSE AREA PRODUCT DALAM PEMERIKSAAN DIGITAL RU Patra Susantri; Sri Dewi Astuty; Siti Hartina; Aandri; Syamsir Dewang; Ayu Hardianti Pratiwi; Arfinna; Ajeng Anggreny Ibrahim
Jurnal Sains dan Pendidikan Fisika Vol. 22 No. 2 (2026): JURNAL SAINS DAN PENDIDIKAN FISIKA
Publisher : Physics Department, Faculty of Mathematics and Natural Sciences, Universitas Negeri Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35580/jspf.v22i2.11741

Abstract

Radiografi umum merupakan modalitas diagnostik yang paling sering digunakan sehingga perlu dilakukan Quality Control yang lebih optimal. Salah satu parameter yang dapat diuji adalah Exposure Index (EI) dan Dose Area Product (DAP) karena akan menentukan ketepatan penyinaran untuk menjamin keselamatan radiasi terutama bagi pasien. Penelitian ini bertujuan menganalisis pengaruh variasi luas kolimasi dan ketebalan terhadap nilai EI dan DAP menggunakan phantom tiruan standar American National Standards Institute (ANSI) dengan pilihan jenis pemeriksaan lumbar. Analisis menggunakan uji statistik yaitu regresi linier berganda untuk melihat pengaruh variabel type pemeriksaan, tebal phantom dan atau luas kolimasi terhadap nilai EI dan DAP dengan metode uji koefisien determinasi dan uji FIT secara simultan. Hasil yang paling besar pengaruhnya adalah variabel tebal phantom dan luas kolimasi dengan nilai maksimum untuk EI dan DAP berturut-turut sebesar 276 (pada kondisi type Large, tebal 10cm, luas 30x30) dan 233 mGy/m2 (pada kondisi type Large, tebal 20cm, luas 40x45). Uji FIT paling signifikan pengaruhnya untuk nilai EI adalah type pemeriksaan yang otomatis menyesuaikan faktor eksposi terutama tegangan, sedangkan untuk nilai DAP sangat dipengaruhi oleh tebal phantom dan luas kolimasi karena generator tabung akan memproduksi dosis sinar X berdasarkan luas kolimasi. Profil nilai EI dan DAP untuk obyek pasien diperoleh nilai EI dan DAP maksimum masing-masing 255 dan 254 mGy/m2. Penelitian ini menegaskan pentingnya pengaturan kolimasi dan ketebalan objek dalam menjaga keseimbangan antara kualitas citra dan keselamatan radiasi pasien. Kata kunci: Dose Area Product, Exposure Index, Phantom ANSI  General radiography is the most frequently used diagnostic modality, so it is necessary to conduct more optimal Quality Control. One of the parameters that can be tested is the Exposure Index (EI) and Dose Area Product (DAP) because it will determine the accuracy of irradiation to ensure radiation safety, especially for patients. This study aims to analyze the effect of variations in collimation area and thickness on EI and DAP values ​​using a standard American National Standards Institute (ANSI) phantom with a choice of lumbar examination types. The analysis uses statistical tests, namely multiple linear regression to see the effect of examination type variables, phantom thickness and/or collimation area on EI and DAP values ​​with the coefficient of determination test method and FIT test simultaneously. The results with the greatest influence are the variables of phantom thickness and collimation area with maximum values ​​for EI and DAP respectively of 276 (in the large type, 10cm thick, 30x30 area) and 233 mGy/m2 (in the large type, 20cm thick, 40x45 area). The FIT test that has the most significant influence on the EI value is the type of examination that automatically adjusts the exposure factors, especially voltage, while the DAP value is greatly influenced by the phantom thickness and collimation area because the tube generator will produce an X-ray dose based on the collimation area. The EI and DAP value profiles for patient objects obtained maximum EI and DAP values ​​of 255 and 254 mGy/m2, respectively. This study emphasizes the importance of adjusting collimation and object thickness in maintaining a balance between image quality and patient radiation safety. Keywords: Dose Area Product, Exposure Index, Phantom ANSI