Patient Dosimetry and Image Quality in Conventional Diagnostic Radiology: A Practical Optimization Experience from a Serbian Hospital

Abstract

The optimization of image quality vs. patient dose is an important task in medical imaging. Maximal validity of optimization has to be based on clinical images. Simultaneous measurement of patient dose levels and image quality assessment is used to investigate possibilities for dose reduction and maintain image quality. The survey was conducted in a general hospital performing more than 60000 images annually and representing typical Serbian practice. For five most frequent diagnostic projections patient exposure was measured using kerma area product meter. Image quality was assessed by experienced radiologists using “European Guidelines on Quality Criteria for Diagnostic radiographic Images”. Following examination types were included into the survey: chest PA, chest LAT, pelvis AP, lumbar spine AP, lumbar spine LAT and pelvis. Comparing actual radiographic technique with recommended technique in European Guidelines, modification of practice was proposed and implemented and image quality was re-assessed. At least 10 adult patients were followed for each projection, before and after corrective actions. Large dose saving without compromising diagnostic information were found for some examination types, showing that this simple method is very efficient dose reduction tool in conventional diagnostic radiology. Also, need for staff training and difficulties related to practical implementation of optimization methods in Serbia were discussed.