Optimisation of imaging technique used in direct digital radiography

The purpose of the study was to optimise the technique employed for AP shoulder and lateral cervical spine examinations following an investigation into image quality, based on clinical assessment, and effective dose, calculated from patient entrance surface dose measurements. A study was therefore conducted in an attempt to determine whether the increased radiation dose to the patient following the introduction of an anti-scatter grid was justified by the level of improvement in image quality. The study, involving 100 patients, was able to demonstrate that the increase in radiation dose to the patient when using an anti-scatter grid for AP shoulder examinations is not justified by the improved image quality. A poor level of inter-rater reliability between the consultants scoring the lateral cervical spine images prevented a firm conclusion from being reached. The fact that all images were of diagnostic quality, however, suggested that the use of the anti-scatter grid was unnecessary. Following completion of the project the hospital involved was informed of all findings.