Abstract

Purpose: Any use of ionizing radiation must be justifi ed and the benefi t must be greater than the harm it causes. Imaging must be performed with the lowest possible dose received by the patient, while maintaining optimal radiographic image quality. Imaging of the lumbar spine is a relatively high dose imaging procedure. This systematic review aims to explore optimisation options to reduce patient exposure, while maintaining radiographic quality during plain lumbar spine imaging. Methods: A systematic review of the literature from the databases Pub Med Central, EBSCOhost including CINAHL, Cochrane Library, Web of Science, Science Direct, DiKUL and Springer Link was conducted. The documents were fully accessible and in the English language. Results: 26 experimental studies were included in the analysis. There are many optimisation methods: changing the tube potential, comparison of diff erent projections, use of shielding, primary beam collimation, increasing the source-to-image receptor distance, compression of the imaged area, using the air gap technique, evaluation of the need for additional projections, and rotating the patient depending on the tube side. On average, the dose is reduced by 44%. Studies that also evaluated the quality of radiographs found all radiographs to be diagnostically acceptable. Conclusion: The results confi rm a reasonable use of methods to optimize radiation exposure and to maintain an optimal image quality of radiographs. A systematic review for each specifi c area in general radiography should be conducted in the future. Keywords: lumbar spine imaging, optimisation, dose reduction, low dose, image quality

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