Assessment of Rejected Radiographs during planar imaging procedures

Abstract

Radiographic Imaging represents the largest source of exposure to ionizing radiation humans from artificial sources. The estimated annual radiation exposure per individual in the United States is 6.20 mSv. This study aims to evaluate the rejection rate at King Khalid Hospital-Al-Kharj retrospectively and to identify the causes of rejection to radiographic technique. This study was carried out at King Khalid Hospital (KKH) and Prince Sultan center for health services (PSCHS) in Al-Kharj City, Saudi Arabia. The radiographs were retrospectively analyzed for seven digital X-ray machines for three consecutive months. Reject rates per technologist and cause for rejection were analyzed. In total, 22552 radiographic images were acquired for 11134 patients (15363 radiographs) obtained over a period of three months. 67.1% (7544 patients) of the patients are males. Two thousand two hundred five patients were pediatric, representing 19.8% of the all-patients group. In total, 50 technologists are working in the radiology departments with different levels of qualification (Diploma, and Bachelor of Science) and experience. 27 (54%) radiography technologist are working at the planar radiography departments. The overall average positioning error is 34.26%, while the anatomical cut-off is 13.37%. Therefore, staff training is recommended to ensure that patients are well positioned regarding patient setup and body positioning with the proper exposure setting. The study showed no significant difference between image receptors in reject analysis, suggesting that operator performance and professional experience are more important factor than type of image receptor. The study showed that screen film radiography (SFR) is still used in many African countries, while computed radiography (CR) and digital radiography (DR) are dominant in Gulf, Europe, and the United States.