Assessment of the Quality of Postero-anterior Chest Radiographs Seen in a North-west Nigerian Tertiary Hospital

Abstract

Objectives: To determine the quality of chest radiographs of adult patients x-rayed at Usmanu Danfodiyo University Teaching Hospital (UDUTH) in accordance with Committee of European Commission (CEC) guidelines on quality criteria and to determine the most common factor that affects the radiographs.
 Materials and Methods: The data was collected retrospectively from the hospital archives using a data capture sheet.
 Results: A total of 266 radiographs were assessed and the age of patients whose radiographs participated in the study ranged from 20-80years. Also, a greater number of male patients 147(55.3%) participated in the study than female patients 119(44.7%). Results from the study revealed that 194(72.93%) and 225(84.59%) radiographs had correct placement of patient details and anatomical marker respectively. Adequate inspiration was achieved in 223(83.83%) radiographs with presence of artifacts seen in only 17(6.39%) radiographs. Thrown-off scapulae out of lung fields was seen in 174(65.41%) radiographs while adequate penetration was demonstrated in 209(78.57%) radiographs. Fog was seen in 16(6.02%) radiographs and rotation was recorded in 86(32.33%) radiographs. Additionally, blurring and darkroom processing faults affected 9(3.38%) and 42(15.79%) radiographs respectively. The most common cause of poor quality chest radiographs was found to be inadequate collimation affecting 110(41.35%) radiographs.
 Conclusion: In terms of overall quality, only about 41(15.41%) radiographs met all criteria for a standard chest radiograph according to committee of European commission.

Evaluation of the Diagnostic Quality of Chest Radiographs

“…All the parameters, except the adequate positioning of scapula out of the lung fields, were less in their study as compared to the present study.Radiographic images of poor diagnostic quality result in repeats and hence more radiation dose to the patients and economic loss to the hospital. The overall quality of chest radiographs was met in only 22.22% of the chest radiographs, similar to in a study done by Okeji et al and Abubakar et al, which is alarming 2,8. This indicates the need for improvisation of the techniques of obtaining chest radiographs.…”

“…The current study even showed a statistically significant association of age with the scapula out of lung fields. The overall image quality of chest radiographs was poor in the study done by Abubakar et al as compared to the present study 8. All the parameters, except the adequate positioning of scapula out of the lung fields, were less in their study as compared to the present study.Radiographic images of poor diagnostic quality result in repeats and hence more radiation dose to the patients and economic loss to the hospital.…”

“…Okeji et al also similar results as the present study. 2 However, the adequacy of the two main criteria responsible for the reduced image quality of chest radiographs was, even more, less in the study findings of Okeji et al and Abubakar et al 8 They found difficulty in the positioning of the pediatric and geriatric population, which contributed to the reduced adequacy of the quality criteria.…”

“…2,8 In the present study, only 17 pediatric patients were included and only four geriatric patients were included. Even in pediatric patients least age was nine years and most were of age 15 years or more.…”