Bone suppression software and KA Imaging’s SpectralDR™ both represent technological advances designed to overcome a long-standing challenge in X-ray imaging: bones obscuring critical soft tissue details. Enhancing internal visualization is essential for accurate diagnosis and treatment, and both solutions aim to address this need.
Since they are used for similar purposes, a question we often get asked is whether SpectralDR™ and bone suppression software do the same thing. The short answer is: no, they don’t. While their goals may align, the way they work is vastly different.
Keep reading to learn the integral differences between these two technologies, bone suppression X-ray software and SpectralDR™.
KA Imaging’s SpectralDR™ Technology
KA Imaging developed and patented a ground-breaking dual-energy subtraction (DES) technology known as SpectralDR™.
Unlike software-based bone suppression methods that rely on algorithms and may require condition-specific optimization, SpectralDR™ employs a physics-based approach to dual-energy subtraction. By capturing multiple energy levels in a single exposure, it inherently differentiates between bone and soft tissue based on their distinct X-ray attenuation properties. This method ensures consistent and reliable visualization across a broad range of pathologies without the need for algorithmic adjustments.
This modern innovation in imaging technology allows images with multiple energies to be acquired all at once with a single exposure. It does this without the presence of motion artifacts seen in traditional dual-energy systems, which makes acquiring accurate X-ray images easy and efficient.
With KA Imaging’s Reveal™ 35C X-ray detector, which utilizes SpectralDR™, three images are generated:
- A traditional DR image, which shows both the soft tissue and bone at once overlapping each other.
- A soft tissue image, which eliminates the appearance of bones and high-density materials to only show the soft tissue.
- A bone image, which strengthens the visibility of the body’s skeletal and/or calcified structures, or even medical devices like tubes.
Thanks to its dual-energy capabilities, primarily bone subtraction, SpectralDR™ is known to provide better visualization of lung nodules, pneumothorax, and pneumonia. Additionally, the soft-tissue subtracted images enhance the visibility of calcifications, lines, tubes, medical devices and retained foreign objects in the body.
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Can’t bone suppression technology do the same thing?
No, bone suppression software cannot perform bone subtraction the same way as SpectralDR™, as it is algorithm-based, rather than physics-based. These algorithms estimate what the soft tissue might look like behind bones by analyzing and modifying existing image data. However, this doesn’t make it the most accurate depiction of what the soft tissue looks like behind the bones.
In contrast, SpectralDR™ physically separates bone and soft tissue information at the time of acquisition, leading to a more accurate and reliable representation of the anatomy.
Bone suppression software reduces the visibility of the ribs digitally, using pre-existing visual information to fill the gaps.
In other words, bone suppression doesn’t actually show you what it looks like behind the bone, rather, it suppresses the visibility of the ribs to make the soft tissue more visible. This means that nodules appearing behind the ribs could be subtracted from the image alongside the ribs.
Additionally, it lacks the identification capabilities of dual-energy solutions like SpectralDR™ — Bone suppression technology cannot identify bone and calcium as it does soft tissue, which makes it difficult to differentiate calcified nodules from other nodules.
Rather than suppressing, SpectralDR™ actually subtracts the bones from the image. Nodules hidden behind the ribs, even if completely obscured, are capable of being revealed using SpectralDR™ technology.
Understanding AI and Algorithmic Bone Suppression Software
Bone suppression is a type of image processing technology which reduces the visibility of rib bones in a chest X-ray using AI or trained algorithms. The goal of this technology is to make the soft tissue around the chest, such as the lungs, more visible.
The bone suppression algorithm is trained using pre-existing X-ray images, including standard images with the bone visible, and images where the bone is removed and only the soft tissue is visible.
Benefits of SpectralDR™ Technology vs. Bone Suppression Software
SpectralDR™ and bone suppression software share many of the same benefits, but there are still some capabilities which set SpectralDR™ apart.
Let’s start with the advantages both techniques share. SpectralDR™ and bone suppression software require a nearly identical radiation dosage. The Reveal™ 35C X-ray detector with SpectralDR™ technology uses the same radiation dose as a regular chest X-ray. Bone suppression software is a post-processing technology which does not require any extra radiation outside of the initial chest X-ray capture.
However, while both techniques aim to improve visualization of lung nodules and other abnormalities, there’s a key distinction in how they work, and how reliably they perform. Bone suppression software attempts to mask bone structures algorithmically, which can help radiologists identify nodules near the ribs. However, because it works by manipulating a standard X-ray image, its effectiveness can vary depending on the case.
In contrast, SpectralDR™ uses physics-based dual-energy subtraction to completely separate bone and soft tissue information at the time of acquisition. This enables the detection of nodules that are fully obscured by bone—cases that might otherwise be missed due to anatomical overlap. Historically, bone opacity has been a significant barrier in pulmonary nodule detection, and dual-energy subtraction has been shown to improve the visualization of lung lesions.
What About Traditional Dual-Energy Systems?
Traditional dual-energy systems were confined to fixed rooms and required dual exposures, making them impractical for many clinical settings—a limitation that helped drive the adoption of bone suppression software. Old dual-energy systems introduced motion artifacts and increased radiation dose, limiting their utility in routine imaging.
Today, those limitations have been overcome. With the advent of single-exposure dual-energy technology like SpectralDR™ in the Reveal 35C, it’s now possible to acquire true dual-energy images using either a fixed or portable detector, without motion artifacts, and with the same dose as a standard chest X-ray. This shift makes physics-based bone subtraction a viable alternative across a wide range of clinical settings
What Sets SpectralDR™ Apart from Bone Suppression Software
What sets SpectralDR™ technology apart from AI and algorithmic bone suppression software is its adaptability and consistency across views and anatomies. Traditional bone suppression software is typically trained on standard chest PA images and optimized for nodule detection in that specific view. As a result, its performance can degrade with variations in patient positioning or anatomical differences, limiting its clinical utility.
SpectralDR™, by contrast, uses physics-based dual-energy material separation—not learned assumptions—so it works consistently across PA, lateral, and oblique views. It’s also not limited to the chest; the same principles apply to other body parts, making SpectralDR™ a more versatile and scalable imaging solution.
SpectralDR™ in Action
Below is a real clinical case captured with the Reveal™ 35C with SpectralDR™ technology. It’s a lateral view – made possible because of SpectralDR™ technology in the Reveal 35C. This is a powerful example of how the spectral radiographic images can improve the visualization of lesions.
In the traditional DR image, no obvious mass is visible at first glance. The area behind the heart appears ambiguous, resembling a calcified joint. This type of anatomical overlap is common in the mediastinum and can obscure subtle findings.
On the Dual-Energy Soft Tissue image, a mass becomes clearly visible—previously hidden behind bone and calcified anatomy. This added clarity enables a more confident interpretation, without the need to reposition the patient or order additional imaging.
The Bone Image isolates the calcified joint, with the sternum and PortoCath line shown in sharper detail, free from soft tissue interference. This complementary view supports better assessment of device placement and improves visualization of dense structures.