Image Quality Assessment of Digital Radiographs Captured by Hand-Held Devices Versus Wall-Mounted Devices: A Retrospective Comparative Study

Background In diagnostic radiology, the image quality of radiographs is paramount for impeccable diagnosis as it is essential for efficient treatment planning and patient care. In comparison to their well-established wall-mounted equivalents, the growing use of handheld devices raises concerns regarding their diagnostic effectiveness by questioning their image quality. Hence, to fully comprehend the clinical importance of handheld X-ray equipment, it is important to look into their image quality for better diagnostic performance. Aim The study aimed to determine the image quality of handheld X-ray units and compare them with wall-mounted X-ray units in routine dental practice based on objectifiable image quality parameters. Materials and Methods For the study, 200 digital radiographic images (102 taken using handheld and 98 using wall-mounted X-ray units) were collected randomly from archives, including radiographs with cone-cut and positional errors. Five observers, three faculty members, and two postgraduates, who were all blinded, subjectively judged the image quality using a five-point rating scale for five individual parameters: contrast, sharpness, cone-cut, and error in vertical and horizontal angulations of position indicating device separately. The mean score for all observers was calculated, and statistical analysis was performed using the Mann-Whitney U test. The scoring of one faculty member experienced in oral radiology as baseline data was used to compare interobserver agreement among the other observers. Results There is a significant difference between the two groups in cone-cut and error in horizontal angulation. There is no significant difference between the two groups when parameters such as contrast, sharpness, and error in vertical angulation are considered. The images from handheld devices showed better image quality (p = 0.006) compared to the wall-mounted device. There was 87% interobserver agreement between the five observers. Conclusion The present study demonstrated a significant difference between the handheld device and the wall-mounted device when all the five parameters including errors are considered to assess the image quality. Hence, handheld devices can be used for regular clinical practice as an alternative to wall-mounted devices. Nevertheless, stringent radiation safety precautions are essential.