Optimising image quality and radiation dose for neonatal incubator imaging

Area of Science:

• Medical Imaging
• Radiography
• Neonatal Care

Background:

• Neonatal radiography often occurs within incubators.
• Limited evidence exists on optimal imaging methods and parameters for neonates in incubators.
• Standardizing and optimizing these examinations is essential.

Purpose of the Study:

• To standardize and optimize neonatal chest radiography within incubators.
• To evaluate the impact of different acquisition parameters on image quality and radiation dose.
• To provide evidence-based recommendations for clinical practice.

Main Methods:

• A neonatal anthropomorphic phantom was imaged in two incubators using a DR system.
• Varied exposure factors, source-to-image distance (SID), and image receptor placement (direct vs. tray).
• Assessed image quality using visual grading analysis (VGA) and contrast-to-noise ratio (CNR); calculated effective dose via Monte Carlo simulation.

Main Results:

• Using the incubator tray significantly reduced VGA and CNR (p < 0.05) while increasing effective dose (p < 0.05).
• Optimal parameters: direct image receptor, 0.5 mAs, 60 kV, 100 cm SID.
• If tray is necessary, adapt parameters to 1 mAs at maximum achievable SID; highest effective dose occurred with tray and 100 cm SID.

Conclusions:

• Incubator trays negatively impact image quality and increase radiation dose during neonatal imaging.
• Direct imaging is optimal; if trays are used, mAs and SID require adjustment.
• Findings inform practice for standardized and optimized neonatal incubator chest imaging.