Comparative Reject Analysis in Conventional Film-screen and Digital Storage Phosphor Radiography

Peer, Siegfried; Peer, R.; Giacomuzzi, Salvatore; Jaschke, Werner

doi:10.1093/oxfordjournals.rpd.a006482

Cited by 27 publications

(22 citation statements)

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“…There is a temptation therefore to set higher exposures than necessary knowing that the number of repeat examinations will be reduced without the risk of over-exposed images. Although introducing obtrusive quantum mottle with lower exposures may be a legitimate concern for radiographers, it is interesting to note the findings of Peer et al that exposure levels have a very limited role to play in rejected digital images and positioning is a much more important parameter [11,12]. This situation obviously requires further investigation and rectification.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown, however, that CR does not necessarily deliver lower doses than conventional radiography [7] and correctly chosen screen-film combinations can match CR performance [8]. It is established, however, that CR significantly reduces the need for repeat radiographs [3,9,10,11,12], which is largely due to the wide exposure latitude of CR systems.…”

Section: Introductionmentioning

confidence: 99%

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Digital radiography: are the manufacturers' settings too high? Optimisation of the Kodak digital radiography system with aid of the computed radiography dose index

Peters¹,

Brennan²

2001

Eur Radiol

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Manufacturers offer exposure indices as a safeguard against overexposure in computed radiography, but the basis for recommended values is unclear. This study establishes an optimum exposure index to be used as a guideline for a specific CR system to minimise radiation exposures for computed mobile chest radiography, and compares this with manufacturer guidelines and current practice. An anthropomorphic phantom was employed to establish the minimum milliamperes consistent with acceptable image quality for mobile chest radiography images. This was found to be 2 mAs. Consecutively, 10 patients were exposed with this optimised milliampere value and 10 patients were exposed with the 3.2 mAs routinely used in the department of the study. Image quality was objectively assessed using anatomical criteria. Retrospective analyses of 717 exposure indices recorded over 2 months from mobile chest examinations were performed. The optimised milliampere value provided a significant reduction of the average exposure index from 1840 to 1570 ( p<0.0001). This new "optimum" exposure index is substantially lower than manufacturer guidelines of 2000 and significantly lower than exposure indices from the retrospective study (1890). Retrospective data showed a significant increase in exposure indices if the examination was performed out of hours. The data provided by this study emphasise the need for clinicians and personnel to consider establishing their own optimum exposure indices for digital investigations rather than simply accepting manufacturers' guidelines. Such an approach, along with regular monitoring of indices, may result in a substantial reduction in patient exposure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Digital radiography: are the manufacturers' settings too high? Optimisation of the Kodak digital radiography system with aid of the computed radiography dose index

Peters¹,

Brennan²

2001

Eur Radiol

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“…Analysis of rejected images yields information about the eciency of the department and is the basis for quality control (QC) and education of the individual technologist. 1 Whereas no one would question the value of performing reject analysis, in a conventional radiology department, the advent of computed radiography (CR) has prompted some investigators to challenge its relevance to electronic radiology operations. This skepticism developed in part because of early reports of extremely low reject rates using CR.…”

mentioning

confidence: 99%

Is Reject Analysis Necessary after Converting to Computed Radiography?

Honea

Blado²,

Ma³

2002

Journal of Digital Imaging

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Reject analysis is an accepted standard of practice for quality assurance in conventional radiology. The need for reject analysis has been challenged by the introduction of computed radiography (CR) because of low reported reject rates and because criteria for improperly exposed images were lacking. Most CR systems include quality control (QC) workstations that are capable of modifying the appearance of images before release, and also of deleting poor images before they are analyzed. Texas Children's Hospital has been using computed radiography since October 1995, and now conducts essentially filmless imaging operations using a large-scale picture archival and communications system (PACS) with fourteen CR units. The QC workstation is a key element of our CR operation; however, the extensive software tools of the workstation are limited in terms of avoiding repeated examinations. Neither the QC workstation nor the PACS itself is designed to support reject analysis, so our task was to design a system that accommodates identification, isolation, and archiving of repeated examinations, making use of our electronic imaging systems. We had already developed transcription codes for our radiologist's examination critique, so we adopted these as codes for rejected images. The technologist at the QC workstation appends the critique code to patient demographic information, modifies other fields to indicate that the image is rejected, and archives as usual. Modified routing tables prevent the release of rejected images but ensure they are available for review. Our frequency and reasons for repeated examinations are comparable to other reports of reject analysis in the literature. The most frequent cause of a repeated examination is mis-positioning. The process of developing the method for capturing repeat, collecting the data, and analyzing it is only one-half of the battle; to achieve an improvement in services, it is necessary to feed back the results to management and staff and to implement training as indicated. It is our intention to share our results with PACS and CR vendors in the hope that they will incorporate some mechanisms for reject analysis into the design of their systems.

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“…The increased cost of laser film compared with conventional film adds to the operating costs, as does the higher maintenance and service costs; however, if film is eliminated by soft-copy reporting or images printed on smaller-sized film, then savings are possible [22]. Further economic savings are also produced as a result of the significant reduction in reject film rates achievable in digital departments [23].…”

Section: Photo-stimulable Phosphor Computed Radiographymentioning

confidence: 99%

Developments in digital radiography: an equipment update

et al. 2001

Eur Radiol

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Digital X-ray imaging technology has advanced rapidly over the past few years. This review, particularly aimed at those involved in using and purchasing such technology, is an attempt to unravel some of the complexities of this potentially confusing subject. The main groups of X-ray imaging devices that are considered are digitisers of conventional radiographs, image-intensifier-based fluorography systems, photostimulable phosphor computed radiography, amorphous selenium-based technology for thorax imaging and flat-panel systems. As well as describing these different systems, we look at ways of objectively assessing their image quality. Concepts that are used and explained include spatial resolution, grey-scale bit resolution, signal-to-noise ratio and detective quantum efficiency. An understanding of these basic parameters is vital in making a scientific assessment of a system's performance. Image processing and techniques are also briefly discussed, particularly with reference to their potential effects on image quality. This review aims to provide a basic understanding of digital X-ray imaging technology and enables the reader to make an independent and educated assessment of the relative merits of each system.

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Comparative Reject Analysis in Conventional Film-screen and Digital Storage Phosphor Radiography

Cited by 27 publications

References 0 publications

Digital radiography: are the manufacturers' settings too high? Optimisation of the Kodak digital radiography system with aid of the computed radiography dose index

Digital radiography: are the manufacturers' settings too high? Optimisation of the Kodak digital radiography system with aid of the computed radiography dose index

Is Reject Analysis Necessary after Converting to Computed Radiography?

Developments in digital radiography: an equipment update

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