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Title: A paediatric X-ray exposure chart

Abstract

The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use withmore » these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.« less

Authors:
 [1]
  1. Department of Medical Imaging, Royal Children's Hospital, Brisbane, Queensland (Australia)
Publication Date:
OSTI Identifier:
22402355
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 61; Journal Issue: 3; Other Information: PMCID: PMC4175850; PMID: 26229655; OAI: oai:pubmedcentral.nih.gov:4175850; Copyright (c) 2014 The Author. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; AUGMENTATION; BEAMS; BIOMEDICAL RADIOGRAPHY; DIAGRAMS; FEMUR; FINGERS; GRIDS; HEAD; IMAGES; QUANTUM EFFICIENCY; RADIATION DOSES; REVIEWS; SKIN

Citation Formats

Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au. A paediatric X-ray exposure chart. Australia: N. p., 2014. Web. doi:10.1002/JMRS.56.
Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au. A paediatric X-ray exposure chart. Australia. doi:10.1002/JMRS.56.
Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au. 2014. "A paediatric X-ray exposure chart". Australia. doi:10.1002/JMRS.56.
@article{osti_22402355,
title = {A paediatric X-ray exposure chart},
author = {Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au},
abstractNote = {The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.},
doi = {10.1002/JMRS.56},
journal = {Journal of Medical Radiation Sciences (Print)},
number = 3,
volume = 61,
place = {Australia},
year = 2014,
month = 9
}
  • Steps were taken to reduce radiation dosage to patients and staff, by use of only high-speed screens and film, and reduction of the area of patient irradiated. One important source of unnecessary radiation is the repeat radiograph, owing to the previous attempts being spolied by movement blur, and attempts to solve this problem are described. A child is naturally apprehensive in the strange surroundings of a radiographic room, and forceful immobilization of the child can only result in refusal to co-operate, causing unnecessary radiation to the patient and attendant staff. A survey of film wastage shows a considerable reduction inmore » the number of unsatisfactory fllms since the adoption of short-exposure techniques. (BBB)« less
  • No abstract prepared.
  • Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico 'Dr. Federico Gomez.' We measured the entrance surface air kerma (K{sub P}) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate imagemore » quality as the tomograph requires a high resolution image in order to operate at its optimum level.« less