BackgroundThe aim of the study was to compare patient radiation dose and image quality in planar lumbar spine radiography using the PA and AP projection in a large variety of patients of both sexes and different sizes.Patients and methodsIn the first phase data of image field size, DAP, effective dose and image quality were gathered for AP and PA projection in lumbar spine imaging of anthropomorphic phantom. In the second phase, data of BMI, image field size, diameter of the patient’s abdomen, DAP, effective dose and image quality were gathered for 100 patients of both sexes who were referred to lumbar spine radiography. The patients were divided into two groups of 50 patients, one of which was imaged using the AP projection while the other the PA projection.ResultsThe study on the phantom showed no statistically significant difference in image field size, DAP and image quality. However, the calculated effective dose in the PA projection was 25% lower compared to AP projection (p =0.008). Measurements on the patients showed no statistically significant difference between the BMI and the image field size. In the PA projection, the thickness of abdomen was 10% (p < 10–3) lower, DAP 27% lower (p = 0.009) and the effective dose 53% (p < 10–3) lower than in AP projection. There was no statistically significant difference in image quality between the AP and the PA projection.ConclusionsThe study results support the use of the PA projection as the preferred method of choice in planar lumbar spine radiography.

The purpose of the research was to determine the effect of the posteroanterior (PA) patient position in lumbar spine imaging on effective dose and the absorbed organ dose. The study was performed on 100 patients that were referred to the lumbar spine radiography that were divided into two equal groups of 50. Body Mass Index, Dose Area Product (DAP), exposure index (EXI), tube time-current (mAs), image field size and the source-patient distance were acquired for each patient. The entrance surface dose (ESD), the effective dose and the absorbed organ doses were calculated. There was no statistically significant difference in the BMI and EXI between the AP and PA projection. The results showed a significant reduction of ESD by 33% and the effective dose by 53% when the PA projection was used. Furthermore, there was a 64% average reduction of the absorbed organ doses to the selected organs.

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Introduction: The literature describes that MLO projection is not done only with angulation of 45° but there is a wider span of angles that can be used. Therefore, we have investigated if the use of alternative angulation in mammographic imaging in relation to specific patient anatomies shows more breast tissue. Methods: MLO mammograms form 491 patients that had a mammography imaging performed at alternative and basic angulation were included in the study. Angulation of 55° was performed when patient had small breasts and convex sternum. The angle of 35° was used for patients with large breasts and concave sternum as well as for patients with shorter thoraxes. Measurements assessed the width of the pectoral muscle, the retromammary part, and the inframammary part of the breast for both projections (alternative and basic). Results: When comparing the angulations of 45° and 55°, all three measured widths were in favor of 55°: the pectoral muscle was on average wider by 4%, the basal part by 1.3%, and the inframammary part by 29%. When comparing angulations of 35° and 45°, at the angulation of 35°, the basal part was wider by 3.3% and inframammary part by 32.4%. There were no differences in the width of the pectoral muscle between mentioned angulations. Conclusion: Based on our results, we recommend the use of a 55° angle as more appropriate for patients with longer thoraxes and small breasts and the use of a 35° angle for those with shorter thoraxes and large breasts.