Optimal Collimation Significantly Improves Lumbar Spine Radiography

Pazanin, Anamaria; Skrk, Damijan; O'Driscoll, Jessica C; McEntee, Mark F.; Mekiš, Nejc

doi:10.1093/rpd/ncaa057

Cited by 7 publications

(14 citation statements)

References 6 publications

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“…Therefore, the image quality benefits of collimation may be more obvious with smaller regions of interest, for example, the canine shoulder or elbow, where larger differences between optimal and extended collimation are possible. It is well-accepted that collimation size can influence image quality as described and demonstrated by Karami et al ( 20 ) and Pazanin et al ( 21 ) who concluded that optimization of collimation resulted in a reduction of the primary collimation field of 40% and in improved image quality, with a significant difference of 24% in 55 patients.…”

Section: Discussionmentioning

confidence: 94%

Collimation and Exposure Parameter Influence Image Quality and Potential Radiation Dose to the Eye Lens of Personnel in Computed Radiography of the Canine Pelvis

et al. 2021

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Introduction: The purpose of this study was to evaluate the effect of collimation on image quality and radiation dose to the eye lenses of the personnel involved in computed radiography of the canine pelvis.Materials and Methods: A retrospective study of canine pelvic radiographs (N = 54) was undertaken to evaluate the relationship between image quality and the degree of field the collimation used. This was followed by a prospective cadaver study (N = 18) that assessed the effects on image quality and on scattered radiation dose of different collimation field areas and exposure parameters. All radiographs were analyzed for image quality using a Visual Grading Analysis (VGA) with three observers. Finally, the potential scattered radiation dose to the eye lens of personnel restraining a dog for pelvic radiographs was measured.Results: The retrospective study showed a slightly better (statistically non-significant) VGA score for the radiographs with optimal collimation. Spatial and contrast resolution and image sharpness showed the greatest improvement in response to minimizing the collimation field. The prospective study showed slightly better VGA scores (improved image quality) with the optimal collimation. Increasing the exposure factors especially the tube current and exposure time (mAs) resulted in improved low contrast resolution and less noise in the radiographs. The potential eye lens radiation dose increased by 14, 28, and 40% [default exposures, increased the tube peak potential (kVp), increased mAs, respectively] as a result of reduced collimation (increased beam size).Conclusion: The degree of collimation has no statistically significant on image quality in canine pelvic radiology for the range of collimation used but does have an impact on potential radiation dose to personnel in the x-ray room. With regard to radiation safety, increases in kVp are associated with less potential scatter radiation exposure compared to comparable increases in mAs.

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Section: Discussionmentioning

confidence: 94%

Collimation and Exposure Parameter Influence Image Quality and Potential Radiation Dose to the Eye Lens of Personnel in Computed Radiography of the Canine Pelvis

et al. 2021

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“…In this study and for all radiographic examinations included, the actual field size was not retrievable owing to the unavailability of the field collimation details in the DICOM header of each image and the possible improper electronic collimation, which may have hidden the actual field dimension of the irradiated body part [24]. Possible systematic patient overexposure due to poor collimation practices may have been concealed with the use of the electronically collimated radiograph for diagnosis [24,[27][28][29][30]. However, it cannot be determined whether the marked increase in the DAP values observed in lateral thoracic spine and lumbar spine examinations is attributable to high dose value or a large field size or both, as field size information is unavailable.…”

Section: Discussionmentioning

confidence: 95%

Patient-Based Dose Audit for Common Radiographic Examinations With Digital Radiology Systems: A Retrospective Cross-Sectional Study

Alshamrani¹,

Alkenawi²,

Honain³

et al. 2021

Cureus

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This study aims to audit radiation doses of adult patients who underwent common diagnostic X-ray examinations and compare dose area product (DAP) values with the established International Diagnostic Reference Level (IDRLs). Retrospective cross-sectional records of 339-patients who underwent 699radiographic examinations between October 2018 and March 2019 were obtained. Patient-related factors, exposure, and DAP data were recorded for the six most common examinations. The mean and 75th percentile of DAPs were recorded and compared to IDRLs values. The 75th percentiles of the locally measured DAPs were below IDRLs for all examinations except for lateral lumbar, AP, and lateral thoracic spine, in which DAP-75th-percentile exceeded all IDRLs by up to 40.7%, 2.8%, 365.5%, respectively. Considering the type of detector used, the mean of the locally measured DAPs significantly exceeded the UK DRLs for the lateral thoracic spine and lateral lumbar spine. Locally measured DAP values were below the IDRLs except for thoracic and lumbar spine projections, which significantly exceeded.

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“…Papers describing optimisation techniques in lumbar spine radiography have been studied in several countries around the world. Those countries are Finland (16), Australia (17,34,39,41), Ireland (18,19,21,22,25), China (20), Sweden (24,26,33), Kuwait (23), United Kingdom (27,30,36), Slovenia (28,35,37), Iran (29,32), Israel (31), Croatia (38) and Malta (40).…”

Section: Results Analysismentioning

confidence: 99%

“…The research methodology was experimental in almost all studies, except for three studies (16,32,39) in which the research methodology was a retrospective study of lumbar spine images. In most cases, the research was performed on an anthropomorphic phantom (17,20,34,41,(22)(23)(24)(25)(29)(30)(31)33), in a few studies the research was performed on patients only (27,(36)(37)(38), and some of them performed a combined study fi rst on a phantom and then on patients (18,19,21,26,28,35,40). The sample size of the examined patient studies varied from study to study.…”

Section: Results Analysismentioning

confidence: 99%

“…The sample size of the examined patient studies varied from study to study. The smallest sample size of patients studied was three (26), and the largest sample size was 110 (38). The investigators studied the radiation dose to the patient and/ or phantom in all papers, but the measurement tool for the dose measurements varied from study to study.…”

Section: Results Analysismentioning

confidence: 99%

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Optimisation of Radiographic Procedures – Lumbar Spine Imaging in General Radiography

Alukić

Zalokar

Mekiš³

2021

MIRTJournal

Self Cite

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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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Optimal Collimation Significantly Improves Lumbar Spine Radiography

Cited by 7 publications

References 6 publications

Collimation and Exposure Parameter Influence Image Quality and Potential Radiation Dose to the Eye Lens of Personnel in Computed Radiography of the Canine Pelvis

Collimation and Exposure Parameter Influence Image Quality and Potential Radiation Dose to the Eye Lens of Personnel in Computed Radiography of the Canine Pelvis

Patient-Based Dose Audit for Common Radiographic Examinations With Digital Radiology Systems: A Retrospective Cross-Sectional Study

Optimisation of Radiographic Procedures – Lumbar Spine Imaging in General Radiography

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