Portable abdomen radiography: moving to thickness-based protocols

• Published in: Pediatric radiology Vol. 48; no. 2; pp. 210 - 215
• Main Authors: Sánchez, Adrian A., Reiser, Ingrid, Baxter, Tina, Zhang, Yue, Finkle, Joshua H., Lu, Zheng Feng, Feinstein, Kate A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2018; Springer Nature B.V
• Subjects: Abdomen; Automation; Data collection; Diagnostic systems; Exposure; Image quality; Imaging; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Portability; Radiation; Radiation effects; Radiographs; Radiography; Radiology; Technologists; Ultrasound; Image quality; Radiography; Exposure index; Protocol design; Radiography protocols; Portable radiography; Children; Abdomen
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-017-4025-4

Background
Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations.
Objective
To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography.
Materials and methods
We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI.
Results
Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart.
Conclusion
Through automated retrieval of data in our systems’ digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography.