Retrospective quality assurance audit of Lateral Cephalometric Radiographs at postgraduate teaching hospital

The objective of our audit was to assess the quality of lateral cephalometric radiographs by investigating the percentage of lateral cephalometric radiographic images that satisfied the good quality standards.

The standard-based retrospective audit was conducted at Riphah International University, Pakistan, from April to September 2018. The sample size was 50 radiographs that were randomly selected from the radiographs taken over one year. The radiographs were graded according to the standards set by the National Radiation Protection Board by two evaluators after the necessary calibration. Moreover, the percentages of images that met the criteria set by the Royal College of Surgeons of England were identified. The data analysis was carried out by the SPSS software version 23.

Out of the 50 radiographs, thirty-one were Grade-I, sixteen were Grade-II and three radiographs were Grade-III. Furthermore, out of the criteria set by Royal College, one criterion met the 100% standard that was correct head positioning. Less frequent errors were comprised of poor visibility of soft tissue structures (16%), teeth not properly occluded (14%), Incorrect positioning of labels (12%), Sella and Nasion not visible (8%). According to the results of the quality assurance audit, the radiographs fell short of the required standards.

Quality assurance by periodic auditing is important to yield radiographs with maximum diagnostic value, minimal errors, and avoid unnecessary radiation exposure by repeat radiographs. Recommendations were made for the formulation and implementation of comprehensive radiation protection regulations, at all the Dental institutes of Pakistan.