The validity and reliability of the exposure index as a metric for estimating the radiation dose to the patient

Erenstein, H.; Browne, Declan; Curtin, S.; Dwyer, rd S J; Higgins, Robert; Hommel, S.F.; Menzinga, J.; Jorge, José; Sauty, M.; Vries, Geert de; England, Andrew

doi:10.1016/j.radi.2020.03.012

Cited by 12 publications

(7 citation statements)

References 5 publications

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“…The statistical analysis used was ANOVA (Analysis of Variance). The ANOVA test results that were significantly different (P≤0.05) showed a significant difference between the EI and BMI values (Erenstein et al, 2020;Drennan et al, 2019).…”

Section: Methodsmentioning

confidence: 88%

Patient dose monitoring using exposure index against body mass index level on chest X-ray examination

Suandayani

Sutapa

Kasmawan

2021

ijls

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The image quality factor is not merely a matter of whether the image is repeated or not, but also has a wide range of information and also has to maintain the protection method for the patient is the reception of the dose due to radiographic action. So it is necessary to monitor the patient's dose using the EI value. The factors that determine the EI value are the exposure factor and the thickness of the object or BMI (Body Mass Index). Exposure factors (kV and mAs) are factors that have been commonly used as patient dose monitoring, where the tube voltage is a component that changes more often with a relatively constant tube current. The study used data on patients with Thoracic examination at the age of 20-65 years which were then categorized into BMI. The analysis was carried out on the EI value contained in the radiographic image. The results showed that BMI in the normal, Light Grade Fat (LGF), Heavy Grade Fat (HGF) categories, respectively, the EI values were 1562, 1679, and 1955 for the female sex, and 1266, 1600, and 1821 for the male gender. Significantly (P?0.05) the EI value showed difference between female and male sexes.

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Section: Methodsmentioning

confidence: 88%

Patient dose monitoring using exposure index against body mass index level on chest X-ray examination

Suandayani

Sutapa

Kasmawan

2021

ijls

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“…Five of the radiographs were reported three times by all human readers. Additionally, the exposure index was collected as indirect indication of digital image quality, i.e., noise [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

A Deep Learning Algorithm for Radiographic Measurements of the Hip in Adults—A Reliability and Agreement Study

et al. 2022

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Hip dysplasia (HD) is a frequent cause of hip pain in skeletally mature patients and may lead to osteoarthritis (OA). An accurate and early diagnosis may postpone, reduce or even prevent the onset of OA and ultimately hip arthroplasty at a young age. The overall aim of this study was to assess the reliability of an algorithm, designed to read pelvic anterior-posterior (AP) radiographs and to estimate the agreement between the algorithm and human readers for measuring (i) lateral center edge angle of Wiberg (LCEA) and (ii) Acetabular index angle (AIA). The algorithm was based on deep-learning models developed using a modified U-net architecture and ResNet 34. The newly developed algorithm was found to be highly reliable when identifying the anatomical landmarks used for measuring LCEA and AIA in pelvic radiographs, thus offering highly consistent measurement outputs. The study showed that manual identification of the same landmarks made by five specialist readers were subject to variance and the level of agreement between the algorithm and human readers was consequently poor with mean measured differences from 0.37 to 9.56° for right LCEA measurements. The algorithm displayed the highest agreement with the senior orthopedic surgeon. With further development, the algorithm may be a good alternative to humans when screening for HD.

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“…Exposure index (EI) values allow for estimates of radiation exposure at the detector (not patient dose) and can be used as a surrogate marker of image quality and signal to noise ( 9 ). Importantly, the EI values can help the technologist know whether proper technique was used for the individual patient size to ensure that ALARA (as low as reasonably achievable) principles are followed ( 10 , 11 ). The target EI chosen was 300, compared with 200 which is used for standard portable CXR, since using a higher kVP with the same target entrance exposure will result in a higher detector exposure because of less attenuation in tissue.…”

Section: Methodsmentioning

confidence: 99%

Social Distancing with Portable Chest Radiographs during the COVID-19 Pandemic: Assessment of Radiograph Technique and Image Quality Obtained at 6 Feet and Through Glass

Gange

Pahade

Cortopassi

et al. 2020

Radiology: Cardiothoracic Imaging

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Purpose To develop a technique that allows portable chest radiography to be performed through the glass door of a patient’s room in the emergency department. Materials and Methods A retrospective review of 100 radiographs (50 [mean age 59.4 ± 17.3, range 22-87; 30 women] performed with the modified technique in April 2020, randomized with 50 [mean age 59 ± 21.6, range 19-100; 31 men] using the standard technique was completed by three thoracic radiologists to assess image quality. Radiation exposure estimates to patient and staff were calculated. A survey was created and sent to 32 x-ray technologists to assess their perceptions of the modified technique. Unpaired Ttests were used for numerical data. A P value < .05 was considered statistically significant. Results The entrance dose for a 50th percentile patient was the same between techniques, measuring 169 µGy. The measured technologist exposure from the modified technique assuming a 50th percentile patient and standing 6 feet to the side of the glass was 0.055 µGy, which was lower than standard technique technologist exposure of 0.088 µGy. Of the 100 portable chest radiographs evaluated by three reviewers, two reviewers rated all images as having diagnostic quality, while the other reviewer believed two of the standard images and one of the modified technique images were non-diagnostic. A total of 81% (26 of 32) of eligible technologists completed the survey. Results showed acceptance of the modified technique with the majority feeling safer and confirming conservation of PPE. Most technologists did not feel the modified technique was more difficult to perform. Conclusions The studies acquired with the new technique remained diagnostic, patient radiation doses remained similar, and technologist dose exposure were decreased with modified positioning. Perceptions of the new modified technique by frontline staff were overwhelmingly positive.

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The validity and reliability of the exposure index as a metric for estimating the radiation dose to the patient

Cited by 12 publications

References 5 publications

Patient dose monitoring using exposure index against body mass index level on chest X-ray examination

Patient dose monitoring using exposure index against body mass index level on chest X-ray examination

A Deep Learning Algorithm for Radiographic Measurements of the Hip in Adults—A Reliability and Agreement Study

Social Distancing with Portable Chest Radiographs during the COVID-19 Pandemic: Assessment of Radiograph Technique and Image Quality Obtained at 6 Feet and Through Glass

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