Comparison and optimisation of imaging techniques in suspected physical abuse paediatric radiography.

This study compares protocols in clinical use for paediatric Suspected Physical Abuse (SPA) radiographic imaging across four NHS Trusts in the UK. The patient dose delivered from a SPA skeletal survey was compared between two sites using different imaging technology. Additionally, the technique in use for the abdomen Anterior-Posterior (AP) radiographic projection was optimised at one of the participant sites. METHODS: Retrospective data collection was performed to compare SPA protocols. Exposure details and patient dose data for SPA skeletal surveys were collected and compared. SPA skeletal surveys were performed on two anthropomorphic paediatric phantoms using two digital systems. Effective dose (ED) was calculated using a dose calculator software (PCXMC v. 2.0) and used as a quantification of the radiation risk. For the optimisation study, abdomen AP radiographs of the phantoms were acquired over a range of tube potentials (40-117 kV) for constant ED on a digital radiography (DR) system. The contrast-to-noise ratio (CNR) between 'bone' and 'soft tissue' in the images was measured and used as an indicator of image quality. RESULTS: This study showed that there is a variation in the protocols and a range of techniques in use for SPA imaging across the four participant sites. The skeletal surveys undertaken on the newborn phantom at two sites resulted in an ED of 57±3 µSv and 90±4 µSv, on the DR unit and digital radiography/fluoroscopy (dRF) unit, respecti...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research