scholarly journals European guidelines on radiographic image quality in chiropractic practice – proposal of a cross-sectional graded classification reporting principle

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Klaus Doktor ◽  
Maria Lind Vilholm ◽  
Aldis Hardardóttir ◽  
Henrik Wulff Christensen ◽  
Jens Lauritsen
Keyword(s):  
Lumbar Spine ◽  
Image Quality ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Quality Criteria ◽  
Cross Sectional ◽  
Radiographic Images ◽  
Reference Dose ◽  
European Guidelines ◽  
Patient Radiation Dose

Abstract Background The Commission of the European Communities (CEC) has published: European Guidelines on Quality Criteria for Diagnostic Radiographic Images. These guidelines are considered a gold standard, recommended for use in quality assurance protocols. The objectives of this study: 1) Propose a graded classification format for Danish chiropractic clinics according to the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. 2) Propose a reporting principle for quality of radiographic images. 3) Document variation in radiation exposure among clinics. Methods This is a cross-sectional study of image quality based on random sampling from 148 chiropractic clinics. Clinics were included if using: 1) Digital radiography and 2) The chiropractic picture and archiving system (KirPACS) at the Nordic Institute of Chiropractic and Clinical Biomechanics (NIKKB) in Denmark. A sample of 296 lumbar spine series were randomly collected from KirPACS (January 2018). Two independent observers reviewed 50 lumbar spine series twice with a 4-week interval, testing intra- and inter-observer reproducibility. The same observers then reviewed the remaining 246 radiographic studies. All studies were evaluated using the CEC Quality Criteria. Patient radiation dose values were retrieved from KirPACS (First quarter of 2020). Results A reporting and classification principle of diagnostic image quality was used in 148 chiropractic clinics. Compliance with the 22 CEC Quality Criteria had proportions ranging from 0.72–0.96 for 18 criteria, while 4 criteria specifying detail and definition ranged between 0.20–0.66. The proposed rating system (A to E) revealed: 18 A clinics, 28 B clinics, 32 C clinics, 25 D clinics and 45 E clinics (A = highest quality; E = lowest quality). The patient radiation reference dose in Denmark is 7 mGy for the AP/PA lumbar spine. Very few clinics exceed the reference dose value, approximately 50% of clinics were below 5 mGy. Conclusion A reporting principle is proposed for a graded classification format based on the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. The Quality Criteria are for the most part met satisfactorily in 148 Danish chiropractic clinics, but important image details are compromised, in most cases, because of low patient radiation doses. The results of a patient radiation dose survey enabled documentation of variation in radiation exposure among chiropractic clinics.

scholarly journals European Guidelines on Radiographic Image Quality in Chiropractic Practice – Proposal of a Cross-Sectional Graded Classification Reporting Principle

2021 ◽  
Author(s):  
Klaus Knarberg Doktor ◽  
Maria Lind Vilholm ◽  
Aldis Hardardóttir ◽  
Henrik Wulff Christensen ◽  
Jens Lauritsen
Keyword(s):  
Lumbar Spine ◽  
Image Quality ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Quality Criteria ◽  
Cross Sectional ◽  
Radiographic Images ◽  
Reference Dose ◽  
European Guidelines ◽  
Patient Radiation Dose

Abstract BackgroundThe Commission of the European Communities (CEC) has published: European Guidelines on Quality Criteria for Diagnostic Radiographic Images. These guidelines are considered a gold standard, recommended for use in quality assurance protocols. The objectives of this study: 1) Propose a graded classification format for Danish chiropractic clinics according to the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. 2) Propose a reporting principle for quality of radiographic images. 3) Document variation in radiation exposure among clinics.MethodsThis is a cross-sectional study of image quality based on random sampling from 148 chiropractic clinics. Clinics were included if using: 1) Digital radiography and 2) The chiropractic picture and achieving system(KirPACS) at the Nordic Institute of Chiropractic and Clinical Biomechanics(NIKKB) in Denmark. A sample of 296 lumbar spine series were randomly collected from KirPACS. Two independent observers reviewed 50 lumbar spine series twice with a 4-week interval, testing intra- and inter-observer reproducibility. The same observers then reviewed the remaining 246 radiographic studies. All studies were evaluated up against the CEC Quality Criteria. Patient radiation dose values were retrieved from KirPACS. ResultsA reporting and classification principle of diagnostic image quality was used in 148 chiropractic clinics. Compliance with the 22 CEC Quality Criteria had proportions ranging from 0.72-0.96 for 18 criteria, while 4 criteria specifying detail and definition ranged between 0.20-0.66. The proposed rating system (A to E) revealed: 18 A clinics, 28 B clinics, 32 C clinics, 25 D clinics and 45 E clinics (A = highest quality; E= lowest quality). The patient radiation reference dose in Denmark is 7 mGy for the AP/PA lumbar spine. Very few clinics exceed the reference dose value, approximately 50 % of clinics were below 5 mGy.ConclusionA reporting principle is proposed for a graded classification format based on the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. The Quality Criteria are for the most part met satisfactory in 148 Danish chiropractic clinics, but important image details are compromised, in most cases, because of low patient radiation doses. The results of a patient radiation dose survey enabled documentation of variation in radiation exposure among chiropractic clinics.

scholarly journals New patient-controlled abdominal compression method in radiography: radiation dose and image quality

2018 ◽  
Vol 7 (5) ◽  
pp. 205846011877286 ◽  
Author(s):  
Oili Piippo-Huotari ◽  
Eva Norrman ◽  
Agneta Anderzén-Carlsson ◽  
Håkan Geijer
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Prone Position ◽  
Quality Criteria ◽  
Abdominal Compression ◽  
Radiographic Images ◽  
Dose Area Product ◽  
Similar Dose ◽  
Significant Difference ◽  
Area Product

Background The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position . Purpose To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography. Material and Methods An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images. Results There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality. Conclusion Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.

Abstract 690: Variability and Predictors of Patient Radiation Dose with Dual Source Cardiac CT: Implications for Future Algorithms to Reduce Patient Radiation Dose

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ron Blankstein ◽  
Rodrigo Pale ◽  
Khurram Nasir ◽  
Amar B Shah ◽  
Hiram Bezerra ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Medical Center ◽  
Pulmonary Veins ◽  
Wide Range ◽  
Significant Difference ◽  
Patient Radiation Exposure ◽  
Patient Radiation Dose ◽  
Scan Length

Intro : DSCT provides improved temporal resolution due to the simultaneous use of two x-ray sources & detectors. Although use of two sources may increase radiation, the DSCT offers key mechanisms to reduce dose (i.e. pitch adaptation, tube current modulation (TCM) & prospective triggering). Thus, our aim was to assess the patient radiation exposure associated with DSCT and identify variations based on the use of different scan related parameters. Methods : Prospective study of a single tertiary medical center where radiation and image quality related data was collected on 304 consecutive patients (pts) presenting for clinical CCT examination. Effective radiation dose was calculated by multiplying the dose-length product × (k=.017 mSv/mGy/cm). Image quality was rated on a subjective IQ score [1=poor to 4=excellent], as well as contrast (CNR) and signal-to-noise (SNR) ratios. Adjusted means of increased radiation dose were calculated based on linear regression models. Results: Among 304 consecutive studies (mean age 56.4, BMI 29.4 kg/m 2 , 37% Female), 60% were performed for coronary evaluation, 8% for CABG, 18% for pulmonary veins and 11% for aortic disease. The average radiation dose was 13.5±9.2mSv [range 0.5–55.5 mSv]. TABLE provides unadjusted and adjusted mean radiation dose for parameters which had a significant univariate association with radiation dose. Independent predictors of lower radiation included low kV, use of TCM, higher pitch, smaller scan length, and regular heart rhythm. Selected use of various TCM algorithms & low KV resulted in no significant difference in IQ, CNR, or SNR. Conclusions : DSCT is associated with a wide range of patient radiation exposure. The variability in dose is due to both controllable parameters (i.e. use of TCM, low kV, scan length) as well as parameters that cannot be altered (i.e. irregular rhythm). These results suggest that individualizing scan protocols may result in lower radiation dose without compromising image quality. Table: Cardiac DSCT Parameters Affecting Patient Radiation Dose

scholarly journals Surgivisio® and O-arm®O2 cone beam CT mobile systems for guidance of lumbar spine surgery: Comparison of patient radiation dose

2021 ◽  
Vol 85 ◽  
pp. 192-199
Author(s):  
Julia Rousseau ◽  
Serge Dreuil ◽  
Céline Bassinet ◽  
Sophie Cao ◽  
Hélène Elleaume
Keyword(s):  
Lumbar Spine ◽  
Radiation Dose ◽  
Spine Surgery ◽  
Cone Beam Ct ◽  
Mobile Systems ◽  
Cone Beam ◽  
Lumbar Spine Surgery ◽  
Patient Radiation Dose

scholarly journals Establishing a quality assurance baseline for radiological protection of patients undergoing diagnostic radiology

2011 ◽  
Vol 15 (3) ◽  
pp. 70 ◽  
Author(s):  
Geoffrey K Korir ◽  
Jeska Sidika Wambani ◽  
Ian K Korir
Keyword(s):  
Quality Control ◽  
Quality Assurance ◽  
Image Quality ◽  
Radiation Exposure ◽  
High Speed ◽  
Quality Criteria ◽  
Patient Dose ◽  
Radiological Protection ◽  
X Ray ◽  
High Speed Film

Background. The wide use of ionising radiation in medical care has resulted in the largest man-made cause of radiation exposure. In recent years, diagnostic departments in Kenya have adapted the high-speed film/screen combination without well-established quality control, objective image quality criteria, and assessment of patient dose. The safety of patients in terms of justification and the as-low-as-reasonably-achievable (ALARA) principle is inadequate without quality assurance measures. Aim. This study assessed the level of film rejects, device performance, image quality and patient dose in 4 representative hospitals using high-speed film/screen combination. Results. The X-ray equipment quality control tests performance range was 67% to 90%, and 63% of the radiographs were of good diagnostic value. The measured prevalent chest examination entrance surface dose (ESD) showed levels above the international diagnostic reference levels (DRLs), while lumbar spine and pelvis examination was the largest source of radiation exposure to patients. Conclusion. The optimisation of patient protection can be achieved with optimally performing X-ray equipment, the application of good radiographic technique, and continuous assessment of radiographic image quality.

scholarly journals Value of whole-body low-dose computed tomography in patients with ventriculoperitoneal shunts: a retrospective study

2018 ◽  
Vol 129 (6) ◽  
pp. 1598-1603 ◽  
Author(s):  
Andrej Pala ◽  
Fadi Awad ◽  
Michael Braun ◽  
Michal Hlavac ◽  
Arthur Wunderlich ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Low Dose ◽  
Whole Body ◽  
Consecutive Series ◽  
Dose Length Product ◽  
Shunt System ◽  
Distal Catheter ◽  
Vp Shunt

OBJECTIVEThe gold standard for evaluation of ventriculoperitoneal (VP) shunt position, dislocation, or disconnection is conventional radiography. Yet, assessment with this modality can be challenging because of low image quality and can result in repetitive radiation exposure with high fluctuation in the radiation dose. Recently, CT-based radiation doses have been significantly reduced by using low-dose protocols. Thus, whole-body low-dose CT (LDCT) has become applicable for routine use in VP shunt evaluation. The authors here compared image quality and approximate radiation dose between radiography and LDCT in patients with implanted VP shunt systems.METHODSVentriculoperitoneal shunt systems have been investigated with LDCT scanning at the authors’ department since 2015. A consecutive series of 57 patients (70 investigations) treated between 2015 and 2016 was retrospectively assessed. A historical patient cohort that had been evaluated with radiography was compared with the LDCT patients in terms of radiation dose and image quality. Three independent observers evaluated projection of the valve pressure level and correct intraperitoneal position, as well as complete shunt projection, using a Likert-type scale of 1–5, where 1 indicated “not assessable” and 5 meant “assessable with high accuracy.” Descriptive statistics and the Mann-Whitney U-test were used for analysis.RESULTSTwenty-seven radiographs (38.6%) and 43 LDCT scans (61.4%) were analyzed. The median dose-length product (DLP) of the LDCT scans was 100 mGy·cm (range 59.9–183 mGy·cm). The median total dose-area product (DAP) of the radiographic images was 3177 mGy·cm2 (range 641–13,833 mGy·cm2). The estimated effective dose (EED) was significantly lower with the LDCT scan (p < 0.001). The median EED was 4.93 and 1.90 mSv for radiographs and LDCT, respectively. Significantly better identification of the abdominal position of the distal shunt catheter was achieved with LDCT (p < 0.001). Simultaneously, significantly improved visualization of the entire shunt system was realized with this technique (p < 0.001). On the contrary, identification of the valve settings was significantly worse with LDCT (p < 0.001).CONCLUSIONSWhole-body LDCT scanning allows good visualization of the distal catheter after VP shunt placement. Despite the fact that only a rough estimation of effective doses is possible in a direct comparison of LDCT and radiography, the data showed that shunt assessment via LDCT does not lead to greater radiation exposure. Thus, especially in difficult anatomical conditions, as in patients who have undergone multiple intraabdominal surgeries, have a high BMI, or are immobile, the use of LDCT shunt evaluation has high clinical value. Further data are needed to determine the value of LDCT for the evaluation of complications or radiation dose in pediatric patients.

Patient radiation dose and image quality in plain radiography: An assessment of three common procedures in ten hospitals

2020 ◽  
Vol 173 ◽  
pp. 108888
Author(s):  
Esameldeen Babikir ◽  
Adel Al-Mallah ◽  
Mahdi Al-Sehlawi ◽  
Nissren Tamam ◽  
Abdelmoneim Sulieman
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Plain Radiography ◽  
Patient Radiation Dose

scholarly journals The Effect of Administered Activity on Patient Radiation dose and Image Quality in SPECT at Korle-Bu Teaching Hospital

2017 ◽  
pp. 204-211
Author(s):  
Issahaku Shirazu ◽  
Theophilus Sackey ◽  
Ernest Kojo Eduful
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Phantom Study ◽  
Acquisition Time ◽  
Image Study ◽  
Dynamic Studies ◽  
Increase With Increase ◽  
Medicine Physician ◽  
Patient Radiation Dose ◽  
Administered Activity

The study discussed two parameters these include; administered activity (patients dose) and image quality. The aim is to determine the relationship between administered activity with resultant patient radiation dose and the quality of images produced. This will help make appropriate recommendation to the technologist and the nuclear medicine physician to produce images that would answer clinical question and at the same time maintain a balance with patient's radiation dose and its prognostic consequences. The study include both quadrant bar phantom study and patient image study in the form of static and dynamic studies. To determine image quality both the quadrant bar phantom and the patients images were assess by using SNR. The quadrant bar phantom was imaged by placing it on flood field uniform phantom which contained the radionuclide. The flood field uniformity phantom was filled with water and then an injected activity, which varied between 5 to 45 mCi of Tc-99 m were added and mixed thoroughly by several shaking for about 5 minutes. Images of the quadrant bar phantom together with real patients’ images with varied injected activities were analyzed. The study shows that as the administered activity increases from 5 to 45mCi the image quality increases significantly, which is based on the increase in SNR. Where the image quality increases from 17.06 to 22.29 in LEAP collimator and 13.56 to 21.51 in LEHR collimator using patients’ static images. In addition, the image quality also increases from 18.26 to 20.44 in LEAP and 13.51 to 21.47 in LEHR collimator using quadrant bar phantom studies. Furthermore, in the of dynamic patients images, the SNR had minimal variation from 5.40 to 29.86 in LEAP and 7.11 to 21.99 in LEHR. Furthermore the reduction in administered activity increases the acquisition time from 7 to 20mins for LEAP collimator and 8 to 22 mins for LEHR collimator. In addition, with the phantom study, the acquisition time increases from 12 to 19 mins for LEAP and 13 to 15 mins for LEHR collimator. Dynamic studies varies slightly in acquisition time just approximately a min increase with increase in administered activity.

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