Abstract

Objective Diagnostic efficacy relies on optimised image quality and in the interest of patients this should not vary across sites for the same investigation. Previous work performed in Sweden reported variations for chest and dental images. The aim of this investigation was to establish if this problem was more widespread and involved several imaging departments ( n = 20) in four countries and a range of examinations. Methods Images produced following patient examinations of the chest, abdomen, pelvis and lumbar spine were assessed using anatomical parameters that were classified into technical and procedural criteria. Results Multiple measurements ( n > 30,000) demonstrated variations in image quality for all examinations types across the hospitals investigated, with the lumbar spine AP projection recording the greatest degree of variation. The method of image analysis employed facilitated the differentiation of causal agents into technical or procedural categories. Conclusions The work demonstrates that X-ray image quality is dependent on the site of investigation and by greater adherence to published recommendations on equipment and technique these variations could be reduced. The authors recommend the method used to differentiate between technical- and procedural-based criteria, so causal agents responsible for image quality variations and corrective action can be more easily identified.

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