{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:43:13Z","timestamp":1793032993850,"version":"4.5.0"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The IEC exposure index (EI), deviation index (DI), and target exposure index (EI\n T<\/jats:sub>\n ), represent critical standardized metrics for the evaluation of exposure and quality in radiographic imaging.\n <\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n \n This work develops and validates a systematic procedure to estimate the EI\n T<\/jats:sub>\n for eight of the most common radiography imaging protocols utilizing automatic exposure control (AEC) from measurements acquired under reference conditions.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A model was developed to define the relationship between a systems AEC logic, and an estimation of the EI under flat\u2010field conditions (EIFFC). Separately, clinical data and acquisition protocol information for resultant EI during patient studies were also collected for the eight protocols studied: Chest posteroanterior (PA), Chest lateral, Abdomen anteroposterior (AP), Pelvis AP, L\u2010Spine AP, C\u2010Spine AP, T\u2010Spine AP, and Ribs AP. Data were collected from 41 x\u2010ray units spanning seven institutions. For each protocol on each unit the EIFFC was computed based on the acquisition protocol, as well as median EI from clinical exams to produce a scaling factor (SF). Kruskal\u2013Wallis statistical tests were used to compare SF's between vendors and AEC cell configurations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n SFs for eight radiographic imaging protocols have been produced per vendor and per AEC cell selection. A workflow has been established for end\u2010users to follow to apply these SFs to flat\u2010field measurements taken at their own locations to establish local EI\n T<\/jats:sub>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The study results show that in seven of the eight imaging protocols, the SFs for most units included in the study report SFs within 1 DI\u00a0(\u00b1\u00a025%) of their respective final vendor reported SF (218\/228). The ribs protocol is the exception to this finding (n\u00a0=\u00a026). SFs have high utility for establishing EI\n T<\/jats:sub>\n values on individual x\u2010ray units and normalizing EI value distributions for quality assurance purposes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.70562","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:38:37Z","timestamp":1777437517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Deriving target exposure indices for common radiography exams based on automatic exposures of flat\u2010field phantoms"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5455-8435","authenticated-orcid":false,"given":"Matthew","family":"Hoerner","sequence":"first","affiliation":[{"name":"Department of Radiology Yale New Haven Health New Haven, CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7995-0671","authenticated-orcid":false,"given":"Emily L.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Florida Gainesville, FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7541-6894","authenticated-orcid":false,"given":"Katie","family":"Hulme","sequence":"additional","affiliation":[{"name":"Department of Radiology Cleveland Clinic Cleveland, OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Radiology Emplify Health by Gundersen La Crosse, WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suha","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Department of Radiology Yale New Haven Health New Haven, CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shady","family":"AlKhazzam","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4971-3215","authenticated-orcid":false,"given":"Zaiyang","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Rochester, MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Durham, NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Scilla","sequence":"additional","affiliation":[{"name":"Associates in Medical Physics Akron, OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Tsalafoutas","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"National Council on Radiation Protection and Measurements.NCRP Report 160 Ionizing radiation exposure of the population of the United States(Bethesda MD 2009)."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13246\u2010024\u201001431\u2010y"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13885"},{"key":"e_1_2_10_5_1","volume-title":"Medical electrical equipment \u2013 exposure index of digital X\u2010ray imaging systems. Part 1, Definitions and requirements for general radiography","year":"2008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radi.2020.02.009"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010010\u20101951\u20109"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9895"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","unstructured":"DaveJK JonesAK FisherR et\u00a0al.Current state of practice regarding digital radiography exposure indicators and deviation indices: report ofAAPM Imaging Physics Committee Task Group 232.Med Phys2018;45(11).","DOI":"10.1002\/mp.13212"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2342040760"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057\u20101976\/ab123b"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/61\/21\/N551"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/51\/21\/006"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/nch548"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70562","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70562","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:30:30Z","timestamp":1793032230000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/acm2.70562"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70562","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"assertion":[{"value":"2025-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70562"}}