Decision Making and Variation in Radiation Exposure Factor Selection by Radiologic Technologists.

Area of Science:

• Radiologic Technology
• Medical Imaging Physics
• Patient Safety

Background:

• Optimizing radiographic imaging requires balancing diagnostic image quality with minimizing patient radiation dose.
• Variations in exposure factor selection among radiologic technologists can lead to suboptimal imaging and unnecessary radiation exposure.
• Understanding the factors influencing exposure parameter choices is crucial for improving clinical practice.

Purpose of the Study:

• To investigate variations in exposure factor (kVp, mAs, SID, grid) selection by radiologic technologists for virtual patients across different body mass index (BMI) categories.
• To explore the correlation between radiographer experience, visual fixation patterns, and exposure parameter assignments.
• To identify potential inconsistencies in radiographic technique and their implications for patient dose optimization.

Main Methods:

• Eleven radiologic technologists were tasked with assigning exposure parameters for four radiographic examinations (AP shoulder, AP/lateral lumbar spine, AP portable chest) on virtual patients representing five BMI categories.
• Eye-tracking data (Tobii TX300) was collected to record visual fixation patterns during exposure selection.
• Statistical analysis was performed to identify significant correlations between variables such as radiographer age/experience, visual fixation times, and selected exposure factors.

Main Results:

• Significant correlations were found between radiographer age/experience and mAs selection for AP shoulder and lumbar spine examinations.
• Increased age/experience was associated with higher mAs for AP shoulder but lower mAs for lumbar spine examinations.
• Strong correlations were observed between fixation times on relevant anatomy and kVp/mAs values for the AP portable chest examination.

Conclusions:

• Differences in exposure parameter selection based on radiographer experience indicate practice inconsistencies.
• The observed variations highlight a need for further investigation into the causes of these inconsistencies and the development of strategies to optimize radiation safety.
• Future research should explore the relationship between visual factors and specific examinations, particularly the AP portable chest, given the findings.