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To determine dose-optimized image acquisition parameters for good image quality (IQ) in neonatal chest radiography with a computed radiography (CR) CsBr needle detector vs. a wireless digital radiography (DR) CsI detector using different doses and filters.Physical resolution of the two detectors in unprocessed imaging of a contrast-detail phantom was automatically evaluated. Post-processed chest radiographic imaging of a neonatal phantom was used for Visual Grading Analysis (VGA) by three radiology raters. Different kVp, mAs, and filter settings were used. The VGA score (VGAS) and dose area product (DAP) were used to determine image acquisition parameters and dose levels for good image quality. Pixel data from segments corresponding to visual grading characteristics (VGC) was used to calculate signal-to-noise ratio, contrast-to-noise ratio (CNR), and signal profile curves. These results were compared to the raters' "ground truth" by Spearman's correlation.The CR detector had the highest resolution in unprocessed imaging, although this was dependent on a tube voltage of 66 kVp (P < 0.001), and more so than the DR detector. The VGAS showed no significant difference between the CR needle and the DR CsI detectors at the same DAP, or when using standard pediatric filtering of 3.5 mm Al + 0.1 mm Cu (P > 0.05). A lung dose level of 0.017 mSv was needed for good IQ (effective dose (): 0.010 mSv). This was achievable with different acquisition parameters. Out of 24 segments, only the CNR of bone-to-soft-tissue had a good Spearman's correlation (ρ > 0.50) to raters' VGAS (P < 0.0001), mostly due to problems with image registration.The CR needle and DR CsI detectors have comparable IQ in neonatal chest radiography. In this study, an of approximately 0.010 mSv was needed for good IQ. · CR needle and DR detectors have comparable image quality in neonatal chest radiography.. · CR needle technology has higher absolute raw image resolution, although this is voltage-dependent and more so than the DR detector.. · We propose ideal image acquisition parameters for neonatal chest radiography.. · Rama K, Esser M, Spogis J et al. Dose-Optimized Image Acquisition Parameters for Neonatal Chest Radiography: A Phantom Study Comparing Computed Radiography and Wireless Digital Radiography Needle Detectors. Rofo 2025; DOI 10.1055/a-2525-9430.

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