Digital radiography retake rates and effect on patient dose

Abstract

Multiple exposures to ionizing radiation subject patients to a greater risk of exposure to unsafe levels of radiation, resulting in the later development of malignancies. This study analyzed the digital radiography retake rates and the effective dose for patients at a general public hospital in Saudi Arabia. This retrospective study, conducted at the Public Hospital Radiological Department between October and November 2021, sought to determine the causes of repeated or rejected radiographic images to maximize patient safety in terms of excess or unwarranted radiation doses. Positioning errors, machine-related issues, anatomy cutoff, artifacts, and body movements were the causes of repeated or rejected radiographic procedures. During this study, 4158 images were collected; among these, 217 were rejected. Most errors in the radiologic department were related to the lack of experience of the staff. Junior and senior staff were directly or indirectly responsible for 87.5% of repeated radiographic procedures, whereas expert-level staff were responsible for 12.4% of the repeated or rejected procedures. Based on these findings, this study proposes a heightened implementation of quality control measures and improvement in staff training to bolster staff skills to actively comply with “as low as reasonably achievable” radiation exposure to patients.