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Flat panel detectors remain a new and emerging technology in under-table fluoroscopy systems. This technology is more susceptible than image intensifiers to electronic noise, which degrades image contrast resolution. Compensation for increased electronic noise is provided through proprietary vendor image processing algorithms. Lacking optimization in pediatrics, these algorithms interfere with patient anatomy particularly in neonate patients with low native anatomic contrast from bony structures, which serve as landmarks during fluoroscopic procedures. Existing phantoms do not adequately mimic the neonate anatomy making assessment and optimization of image quality for these patients difficult if not impossible. This work presents a method to inexpensively print iodine based anthropomorphic phantoms derived from patient radiographs with sufficient anatomic detail to assess system image quality. First, the attenuation of iodine ink densities (μt) was correlated to a standard pixel value grayscale map. Next, for proof-of-principle, radiographs of an anthropomorphic chest phantom were developed into a series of iodine ink printed sheets. Sheets were stacked to build a compact 2D phantom matching the x-ray attenuation of the original radiographs. The iodine ink printed phantom was imaged and attenuation values per anatomical regions of interest were compared. This study provides the fundamentals and techniques of phantom construction, enabling generation of anatomically realistic phantoms for a variety of patient age and size groups by use of clinical radiographs. Future studies will apply these techniques to generate neonatal phantoms from radiographs. These phantoms provide realistic imaging challenges to enable optimization of image quality in fluoroscopy and other projection-based x-ray modalities.
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