What happens to image contrast if the x-ray beam is consistently too low in kilovoltage?

When the x-ray beam is consistently too low in kilovoltage, the energy of the x-rays produced is insufficient to penetrate thicker or denser tissues effectively. This leads to a higher attenuation of the beam as it passes through various body parts, meaning that fewer x-rays reach the image receptor.

As a result, tissues that have differing densities—such as fat, muscle, and bone—produce more significant differences in the amount of x-ray exposure, creating a greater distinction between light and dark areas on the image. This situation typically occurs in low-kilovoltage radiography because the lower energy x-rays are absorbed more by denser tissues, enhancing the contrast in the image.

However, while there can be a degree of contrast enhancement, it often comes with the drawback of increased noise and a higher likelihood of underexposure for certain areas, which could lead to an overall reduction in image quality. In general, using low kilovoltage results in increased contrast at the expense of overall diagnostic quality. Therefore, it can be understood that a consistently low kilovoltage will lead to decreased contrast in terms of diagnostic clarity, as the potential for optimal image quality diminishes.