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Optimising default radiographic exposure factors using Deviation Index.

A Creeden1, M Curtis1

  • 1Radiology Department, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK.

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|March 23, 2020
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Summary
This summary is machine-generated.

Monitoring Deviation Index (DI) values and optimizing exposure settings in digital radiography significantly reduces patient radiation doses. This quality assurance approach ensures safer imaging practices by aligning exposures with recommended ranges.

Keywords:
Deviation indexDigital radiographyExposure indexHealthcare quality assuranceOptimizationRadiation exposure

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Area of Science:

  • Medical Imaging
  • Radiologic Technology
  • Radiation Dose Management

Background:

  • Radiographers must minimize patient radiation doses using digital radiography.
  • Deviation Index (DI) values offer feedback on exposure appropriateness and aid quality assurance.
  • Optimizing exposure factors balances image quality and patient dose.

Purpose of the Study:

  • To assess the impact of optimizing digital radiography exposure settings on Deviation Index (DI) values.
  • To evaluate the effectiveness of a quality assurance program focused on DI monitoring and exposure parameter adjustment.

Main Methods:

  • Exposure logs from six digital radiography systems were analyzed.
  • Five common examinations with frequent out-of-range DI values were identified for optimization.
  • Default exposure settings (mAs) were iteratively modified and re-evaluated over 18 months.

Main Results:

  • Initial DI values outside the optimal range (-3 to +2) were 36.0% overall, reaching 74.5% for some exams.
  • Following optimization, the overall proportion of out-of-range DI values decreased to 28.4%.
  • Default milliampere-seconds (mAs) values were reduced by 22% to 50% for targeted examinations.

Conclusions:

  • Routine monitoring of DI values and targeted optimization of exposure settings demonstrably reduce patient radiation doses.
  • Implementing a departmental quality assurance program for DI monitoring is crucial for dose reduction.
  • Radiographers require a thorough understanding of DI values to select appropriate exposure settings.