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Spahn M, Strotzer M, Völk M, et al. Digital radiography with a large-area, amorphous-silicon, flat-panel x-ray detector system. Invest Radiol 2000;35:260–266.To investigate the image quality of a digital radiography system with an amorphous-silicon, large-area, digital flat-panel detector.A flat-panel detector based on a matrix of amorphous silicon was integrated into a projection radiography system. The scintillator consisted of a layer of structured cesium iodide. The active matrix size of 30002 pixels together with a pixel size of 143 μm provided a large image area of 43 × 43 cm2. Basic image quality parameters such as detective quantum efficiency (DQE) and modulation transfer function (MTF) were measured and compared with those obtained with conventional systems.The measurement of DQE yielded a high value of 70% at zero spatial frequency. At a system dose equivalent to 400 speed, the DQE of the digital system was a factor of two larger than the DQE of a storage phosphor or screen-film system within the entire spatial frequency range between zero and the Nyquist limit of 3.5 line pairs per millimeter. The flat-panel detector furthermore has an MTF that is superior to that in regular screen-film systems and also provides a substantially larger dynamic range.This new technology demonstrates its potential to provide equal or superior image quality to conventional screen-film systems and to reduce patient exposure to radiation dose. The advantages of digital radiography systems, based on a flat-panel detector as an instant image display, facilitation of work flow in the radiology department, and digital networking and archiving, are well in sight.