The assessment of image quality and diagnostic value in X-ray images: a survey on radiographers’ reasons for rejecting images

Insights into Imaging - Tập 13 - Trang 1-6 - 2022
Elin Kjelle1, Catherine Chilanga1
1Faculty of Health and Social Sciences, Department of Optometry, Radiography and Lighting Design, University College of Southeast Norway, Notodden, Norway

Tóm tắt

Assessing the quality of diagnostic images is subjective and influenced by factors such education, skills, and experience of the assessor. This study aims to explore the radiographers’ assessments of medical usefulness or rejection of X-ray images in specific cases. Eighty-one radiographers from different countries responded to the questionnaire distributed online at the EFRS research HUB at ECR 2020 (a 15% response rate). Forty-two percent of the respondents practiced in the UK and Ireland. In addition to rejecting or keeping images in the presented 30 cases and giving a main reason for the images rejected, the participants explained their choice using comments, 1176 comments were obtained. Sixty percent of the comments were on kept images. The respondents kept on average 63% of the images. In the “Keep”, “Could keep”, and “Reject” categories on average 84%, 63% and 43% of images were kept respectively. The most common reasons given for rejecting an image were suboptimal positioning and centering. Potential diagnostic value and radiation protection were indicated as reasons to keep an image perceived as of low quality reported in n = 353 and n = 33 comments respectively. There is an agreement internationally on what makes a good quality X-ray image. However, the opinion on medical usefulness of images of low or poor quality compared to image criteria varies. Diagnostic capability and radiation protection was the rationale used for keeping images not fulfilling image criteria. There seems to be a need for diagnostic quality to be included in image assessment in clinical practice.

Tài liệu tham khảo

Carmichael JHE, Maccia C, Moores BM et al (2000) European guidelines on quality criteria for diagnostic radiographic images. EU Publication Maccia C, Moores BM, Wall BF (1997) The 1991 CEC trial on quality criteria for diagnostic radiographic images: detailed results and findings. EN Luxembourg Office for Official Publication of the European Communities Jones AK, Heintz P, Geiser W et al (2015) Ongoing quality control in digital radiography: report of AAPM Imaging Physics Committee Task Group 151. Med Phys 42:6658–6670. https://doi.org/10.1118/1.4932623 International Atomic Energy Agency (IAEA) (2018) Radiation protection and safety in medical uses of ionizing radiation, IAEA Safety Standards Series No. SSG-46. IAEA: Vienna. https://www-pub.iaea.org/MTCD/Publications/PDF/PUB1775_web.pdf. Accessed 10 Aug 2021 International Commission on Radiological Protection ICRP (2013) Radiological protection in paediatric diagnostic and interventional radiology publication 121. Ann ICRP 42:1–63. https://doi.org/10.1016/j.icrp.2012.10.001 Almalki AA, Manaf RA, Juni MH, Hayati KS, Noor NM, Gabbad AAM (2017) A Systematic review on repetition rate of routine digital radiography. Int J Curr Res 9:46325–46330 Lin C, Chan P, Huang K, Lu C, Chen Y, Lin Chen Y (2016) Guidelines for reducing image retakes of general digital radiography. Adv Mech Eng. https://doi.org/10.1177/1687814016644127 Taylor N (2015) The art of rejection: comparative analysis between Computed Radiography (CR) and Digital Radiography (DR) workstations in the Accident & Emergency and General radiology departments at a district general hospital using customised and standardised reject criteria over a three year period. Radiography 21:236–241. https://doi.org/10.1016/j.radi.2014.12.003 Brink JA, Amis SE (2010) Image wisely: a campaign to increase awareness about adult radiation protection. Radiology 257:601–602. https://doi.org/10.1148/radiol.10101335 Dunn MA, Rogers AT (1998) X-ray film reject analysis as a quality indicator. Radiography 4:29–31. https://doi.org/10.1016/S1078-8174(98)80027-8 Kjelle E, Schanche AK, Hafskjold L (2021) To keep or reject, that is the question—a survey on radiologists and radiographers’ assessments of plain radiography images. Radiography (Lond) 27:115–119. https://doi.org/10.1016/j.radi.2020.06.020 Mount J (2016) Reject analysis: A comparison of radiographer and radiologist perceptions of image quality. Radiography 22:e112–e117. https://doi.org/10.1016/j.radi.2015.12.001 Whaley JS, Pressman BD, Wilson JR, Bravo L, Sehnert WJ, Foos DH (2013) Investigation of the variability in the assessment of digital chest X-ray image quality. J Digit Imaging 26:217–226. https://doi.org/10.1007/s10278-012-9515-1 Sl L, Mak AS, Lam W, Chau C, Lau K (2004) Reject analysis: a comparison of conventional film–screen radiography and computed radiography with PACS. Radiography 10:183–187. https://doi.org/10.1016/j.radi.2004.03.014 Waaler D, Hofmann B (2010) Image rejects/retakes-radiographic challenges. Radiat Prot Dosimetry 139:375–379. https://doi.org/10.1093/rpd/ncq032 Waaler D, Hammer S, Langdalen C, Haug LTH (2017) How radiographers visually perceive X-ray images with the task of accepting or rejecting them—a pilot study. Radiography Open 3(1):10. https://doi.org/10.7577/radopen.1997 Saade C, Siblini L, Karout L et al (2021) To repeat or not to repeat: Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate during mobile chest radiography. Radiography (Lond) 27:304–309. https://doi.org/10.1016/j.radi.2020.09.003 Mercieca N, Portelli JL, Jadva-Patel H (2017) Mammographic image reject rate analysis and cause—a National Maltese Study. Radiography (Lond) 23:25–31. https://doi.org/10.1016/j.radi.2016.07.004 Atkinson S, Neep M, Starkey D (2020) Reject rate analysis in digital radiography: an Australian emergency imaging department case study. J Med Radiat Sci 67:72–79. https://doi.org/10.1002/jmrs.343 Hofmann B, Rosanowsky TB, Jensen C, Wah KH (2015) Image rejects in general direct digital radiography. Acta Radiol Open 4:2058460115604339. https://doi.org/10.1177/2058460115604339 Mc Fadden S, Roding T, de Vries G, Benwell M, Bijwaard H, Scheurleer J (2018) Digital imaging and radiographic practise in diagnostic radiography: an overview of current knowledge and practice in Europe. Radiography (Lond) 24:137–141. https://doi.org/10.1016/j.radi.2017.11.004 Ohta Y, Matsuzawa H, Yamamoto K, Enchi Y, Kobayashi T, Ishida T (2021) Development of retake support system for lateral knee radiographs by using deep convolutional neural network. Radiography (Lond). https://doi.org/10.1016/j.radi.2021.05.002 Frush D (2021) The cumulative radiation dose paradigm in pediatric imaging. Br J Radiol 94(1126):20210478. https://doi.org/10.1259/bjr.20210478 Altman DG (2020) Practical statistics for medical research, 2nd edn. Chapman and Hall, London