Bedside chest radiography

Bedside chest radiography is one of the most frequently performed radiologic examinations, yet it is the examination with the most variation in image quality. The need to improve the quality of this examination has long been recognized, but it is a difficult problem to solve. Critically ill patients must undergo bedside chest radiography almost daily. These examinations are useful 76%-94% of the time. A national survey revealed that there is a wide variation in the methods used to perform bedside chest radiography, indicating that there is no excellent preferred technique. The reduced image quality is due to scatter radiation. The scatter fraction is about 0.95 in the mediastinum and is about 0.66 in the lung. When grids are used, the image quality is improved; acceptance has been slow, however, because the grid is frequently misaligned. Storage phosphor imaging/computed radiography with grids is a technology improvement that almost completely solves this problem. Radiologists should be sure to optimize the current techniques, as well as provide prompt examination reporting.