In the detective quantum efficiency (DQE) evaluation of detectors for digital radiography (DR) systems, physical image quality indices such as modulation transfer function (MTF) and normalized noise power spectrum (NNPS) need to be accurately measured to obtain highly accurate DQE evaluations. However, there is a risk of errors in these measurements. In this study, we focused on error factors that should be considered in measurements using clinical DR systems. We compared the incident photon numbers indicated in IEC 62220-1 with those estimated using a Monte Carlo simulation based on X-ray energy spectra measured employing four DR systems. For NNPS, influences of X-ray intensity non-uniformity, tube voltage and aluminum purity were investigated. The effects of geometric magnifications on MTF accuracy were also examined using a tungsten edge plate at distances of 50, 100 and 150 mm from the detector surface at a source-image receptor distance of 2000 mm. The photon numbers in IEC 62220-1 coincided with our estimates of values, with error rates below 2.5%. Tube voltage errors of approximately ±5 kV caused NNPS errors of within 1.0%. The X-ray intensity non-uniformity caused NNPS errors of up to 2.0% at the anode side. Aluminum purity did not affect the measurement accuracy. The maximum MTF reductions caused by geometric magnifications were 3.67% for 1.0-mm X-ray focus and 1.83% for 0.6-mm X-ray focus.
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