Guidelines for anti-scatter grid use in pediatric digital radiography

Fritz, Shannon; Jones, A. Kyle

doi:10.1007/s00247-013-2824-9

Cited by 21 publications

(8 citation statements)

References 11 publications

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“…A statistical comparison of the distributions of patient weights in each sub-group was thus performed to check for this potential source of bias. The results of other studies also report a reduction in dose after removal of the grid, while the level of reduction varies considerably from study to study (7). The results of our study show that removing the grid did not reduce the image quality.…”

Section: Discussionsupporting

confidence: 65%

The effect of anti-scatter grid on radiation dose in chest radiography in children

Šabič

2016

Pedaiatr Today

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Section: Discussionsupporting

confidence: 65%

The effect of anti-scatter grid on radiation dose in chest radiography in children

Šabič

2016

Pedaiatr Today

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“…Older children in general have a larger body mass (weight and thickness), causing more scattered radiation [ 21 ] that can be corrected by the software. Therefore, anti-scatter grids should only be used for older children [ 8 ] or according to newer insights for chest sagittal diameter greater than 12–15 cm [ 22 ]. Further, use of SimGrid was more effective for higher exposure conditions, which also relates to greater mass and body thickness of older patients causing more scattered radiation.…”

Section: Discussionmentioning

confidence: 99%

“…As previously mentioned, there are guidelines suggesting the use of anti-scatter grids for children older than 8 years [ 8 ]. There are also publications demonstrating that the sagittal diameter is a better factor [ 1 ] than patient weight and might be included in future guidelines [ 22 ]. As chest diameter of the patients was not available in our system, we grouped patients based on their weight.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the post-processing algorithms SimGrid and S-Enhance for paediatric intensive care patients and neonates

et al. 2022

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Background Post-processing software can be used in digital radiography to achieve higher image quality, especially in cases of scattered radiation. SimGrid is a grid-like software based on a Convolutional Neuronal Network that estimates the distribution and degree of scattered radiation in radiographs and thus improves image quality by simulating an anti-scatter grid. S-Enhance is an algorithm programmed to improve contrast visibility of foreign material. Objective The objective of this study was to evaluate the SimGrid and S-Enhance digital radiography post-processing methods for neonatology and paediatric intensive care. Materials and Methods Two hundred and ten radiographs from the neonatal (n = 101, 0 to 6 months of age) and paediatric (n = 109, 6 months to 18 years of age) intensive care units performed in daily clinical routine using a mobile digital radiography system were post-processed with one of the algorithms, anonymized and then evaluated comparatively by two experienced paediatric radiologists. For every radiograph, patient data and exposure data were collected and analysed. Results Analysis of different radiographs showed that SimGrid significantly improves image quality for patients with a weight above 10 kg (range: 10–30 kg: odds ratio [OR] = 6.683, P < 0.0001), especially regarding the tracheobronchial system, intestinal gas, and bones. Utilizing S-Enhance significantly advances the assessment of foreign material (OR = 136.111, P < 0.0001) and bones (OR = 34.917, P < 0.0001) for children of all ages and weight, whereas overall image quality decreases. Conclusion SimGrid offers a differentiated spectrum in image improvement for children beyond the neonatal period whereas S-Enhance especially improves visibility of foreign material and bones for all patients.

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“…In pediatric cardiac catheterization, Gould et al [27] reported a 30% decrease in DNA double-strand breakages with grid removal. Fritz et al [28] also found that the benefit of the antiscatter grid in pediatric abdominal radiographs decreases in smaller patients and proposed not using it in certain situations. They discussed that some high patient contrast situations, such as evaluating for air-fluid levels, do not require as high of contrast to adequately evaluate.…”

Section: Discussionmentioning

confidence: 99%

Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

Lawing

Gorbe

Maciel

et al. 2022

Journal of Pediatric Orthopaedics B

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The purpose of this study was to examine whether measurement accuracy is impacted with a low radiation radiograph technique. Treatment decisions for hip dysplasia require serial radiographs to monitor acetabular anatomy. However, radiation use creates concern for future malignancy. Standard radiograph technique utilizes a grid to enhance clarity, but requires a larger X-ray dose. We hypothesized grid removal would lower radiation exposure without decreasing measurement accuracy. This is a retrospective cohort study of patients with idiopathic DDH and neuromuscular hip displacement at a single institution from 2019 to 2020 receiving surveillance radiographs. A cohort receiving modified technique radiographs (grid removed) was compared to an age-matched cohort receiving standard technique radiographs. Four examiners measured radiographs on two separate occasions, a minimum of 2 weeks apart. Migration percentage (MP) was measured for neuromuscular patients and acetabular index (AI) for idiopathic DDH. Intraclass correlation coefficient (ICC) with a 95% confidence interval (CI) was used to evaluate inter-observer and intra-observer agreement for measurements. Average radiation dose for both techniques. A total of 134 age-matched patients were included for measurement of MP. Thirty age-matched patients were included for AI measurements. Inter and intra-rater reliability of MP and AI were not different with or without use of the grid. There was a 50–75% decrease in radiation dose per radiograph following grid removal, dependent on patient size. The adjusted radiograph technique showed no significant difference in MP or AI reliability. A slight decrease in picture contrast did not jeopardize measurement reliability and decreased radiation exposure for the patient significantly. This simple technique can be useful for patients requiring multiple radiographs over time.

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Guidelines for anti-scatter grid use in pediatric digital radiography

Abstract: Removing the anti-scatter grid for small patients reduces patient dose without a substantial increase in scatter-to-primary ratio when the FOV is restricted appropriately. Radiologic technologists should base anti-scatter grid use on patient thickness and FOV rather than age.

Cited by 21 publications

References 11 publications

The effect of anti-scatter grid on radiation dose in chest radiography in children

The effect of anti-scatter grid on radiation dose in chest radiography in children

Evaluation of the post-processing algorithms SimGrid and S-Enhance for paediatric intensive care patients and neonates

Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique

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