How Far Old Technology and Practices Are in Use in Radiology?

Abstract

Diagnostic radiology has been undergoing fast changes in technology and practices that have implications on radiation safety of the patient. Some of the changes have well established role in patient protection like use of rare earth intensifying screens in radiography, low attenuating material in patient’s table, and use of image intensifiers rather than conventional dark room fluoroscopy. For many countries in West, it may be unimaginable that older technologies are still in use or the practices such as use of fluoroscopy. For many countries in West, it may be unimaginable that older technologies are still in use or the practices such as use of fluoroscopy for positioning in radiography. A survey was conducted covering large number of developing countries in order to assess the use of old technology and practices. The survey included: age of the machine(>31 years, 21-30 yrs, 11-20 and ≤ 10 yrs), generator type for adult and pediatric radiography (single phase, three phase or high frequency), availability of minimum filtration of 2.5mm of AI, low attenuating material in cassettes and patient table, speed of the screens in the cassettes (200, 400 or more), use of mass screening for chest, use of fluoroscopy for positioning in radiography, use of low kV technique in chest radiography, appropriate awareness about radiation exposures in pregnancy and when termination is not necessary and availability of single slice CT scanners. The most striking features of the survey were: there are number of countries where calcium tungstate screens are still in use rather than rare earth screens that implies patient doses almost double than those in developed countries, many hospitals still use 200 screen speed, manual processing is used frequently, dark room fluoroscopy is still in use in very many hospitals although there are clear recommendations to replace these units, use of low kV technique for chest radiography is rather rampant, there are hospitals where adult exposure factors are in use for CT scans of children.