Preliminary optimization of paediatric chest X-ray examinations across a fleet of devices

Area of Science:

• Medical Imaging Physics
• Radiological Sciences
• Radiation Protection

Background:

• Paediatric chest X-ray examinations require optimized radiation doses to balance diagnostic quality and patient safety.
• Existing digital and computed radiography systems from various vendors present challenges in standardizing dose optimization strategies.
• National diagnostic reference levels (DRLs) and achievable dose level curves provide benchmarks for acceptable radiation exposure.

Purpose of the Study:

• To develop and evaluate a practical, scalable preliminary method for optimizing paediatric chest X-ray examinations.
• To harmonize dose optimization across diverse radiography systems within a large private healthcare network.
• To align radiation exposure levels with Finnish Radiation and Nuclear Safety Authority guidelines.

Main Methods:

• Implementation of a reference device for dose measurement and calibration.
• Calculation of conversion factors for milliampere-second (mAs) normalization.
• Application of a harmonized optimization strategy across multiple digital and computed radiography systems.
• Comparison of optimized exposure values across different equipment vendors.

Main Results:

• The preliminary method successfully achieved similar or near-similar optimized exposure values across a wide range of radiography systems.
• The approach demonstrated effectiveness in harmonizing dose optimization strategies.
• The method proved practical and scalable for implementation in a multi-vendor healthcare setting.

Conclusions:

• The developed preliminary method offers a viable strategy for optimizing paediatric chest X-ray doses.
• Further device-specific optimization is recommended, especially for newer technologies enabling greater dose reduction.
• The study highlights the potential for broader implementation of harmonized dose optimization in paediatric radiography.