No abstract

Objective: The purpose of this review is to investigate the effectiveness of adjusting radiographic technique parameters on image quality of projectional radiographs acquired on a direct digital radiography system. Introduction: Projectional radiography performed with direct digital detectors is now commonplace in many medical imaging departments across the world. While the acquisition technology has advanced, it appears that many sites have not optimized their radiographic technique factors for this new technology. The aim of this review is to uncover evidence to support the continued use of these traditional technique parameters or to suggest changes in clinical practice that would produce optimized results. Inclusion criteria: The review will consider studies that include projectional radiographs acquired on a direct digital radiography system of the axial and appendicular skeleton. Only studies that investigate a human subject (living or post-mortem), or an anthropomorphic phantom will be included. Studies that directly investigate the effect of changing a technique parameter on the resultant image quality and the effect on patient dose will be included. Methods: A comprehensive search of both published and unpublished literature will be performed to uncover studies meeting the inclusion criteria. Studies will be screened for inclusion by two reviewers and disagreements resolved through discussion or with a third reviewer. Studies included in final analysis will be critically appraised for methodological quality. Data will be extracted by a single reviewer and checked by the author team for accuracy. Statistical meta-analysis and subgroup analyses will be performed as appropriate, and a Summary of Findings created. Systematic review registration number: PROSPERO CRD42019137806