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Reject Analysis in Digital Radiography and Computed Tomography: A Belgian Imaging Department Case Study.

Laura Haddad1, Hanna Saleme2, Nigel Howarth3

  • 1Universitélibre de Bruxelles, Belgium.

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|December 25, 2023
PubMed
Summary
This summary is machine-generated.

This study establishes a benchmark for analyzing rejected medical imaging exams. While computed tomography (CT) rejections are less frequent than digital radiography (DR), they incur significantly higher radiation doses, necessitating systematic monitoring of both.

Keywords:
Computed TomographyDigitalDose optimizationDose-Length-ProductDose-area-productEffective doseProtocol optimizationRadiography

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Area of Science:

  • Radiology
  • Medical Imaging Quality Assurance
  • Radiation Dose Management

Background:

  • Reject analysis is crucial for quality assurance in digital radiography (DR).
  • Data on computed tomography (CT) reject analysis is limited.
  • A standardized method for comparing DR and CT rejects is needed.

Purpose of the Study:

  • To establish a straightforward benchmark for reject analysis in both DR and CT.
  • To compare reject rates, reasons, and associated radiation doses for DR and CT.

Main Methods:

  • Retrospective observational study of 107,277 DR and 20,659 CT acquisitions over 18 months.
  • Rejected acquisitions identified using the Dose Archiving and Communication System (DACS).
  • Analysis included reject rates, causes, and supplementary radiation dose.

Main Results:

  • DR reject rate was 8.3%; CT reject rate was 2.5%.
  • Cumulative effective dose (ED) for DR rejects was 377.3 mSv; for CT rejects, it was 1267.4 mSv.
  • Incorrect patient positioning was the primary reason for rejection in both DR (61%) and CT (44%).

Conclusions:

  • A simple, reproducible method for simultaneous DR and CT reject analysis was developed.
  • CT rejects, though less frequent, contribute substantially higher radiation doses, highlighting the need for systematic monitoring.
  • Understanding rejection patterns can guide improvements in imaging techniques and technologist training.