OPTIMISATION OF RADIOGRAPHIC PROCEDURES – LUMBAR SPINE IMAGING IN GENERAL RADIOGRAPHIC IMAGING

Abstract

Purpose: Any use of ionizing radiation must be justified, and the benefit must be greater than the harm it causes. Imaging must be performed with the lowest possible dose received by the patient while maintaining optimal radiographic image quality. Imaging of the lumbar spine is a relatively high dose imaging procedure. This systematic review aims to explore optimization options to reduce patient exposure while maintaining radiographic quality during plain lumbar spine imaging.

Methods: A systematic review of the literature from the databases Pub Med Central, EBSCOhost including CINAHL, Cochrane Library, Web of Science, Science Direct, DiKUL and Springer Link. The documents were fully accessible and in English language.

 Results: 26 experimental studies were included in the analysis. There are many optimization methods: changing the tube potential, comparisons of different projections, use of shielding, primary beam collimation, increasing the source-to-image receptor distance, compression of the imaged area, using the air gap technique, evaluation of the need for additional projections, and rotating the patient depending on the tube side. On average, the dose is reduced by 44%. Studies that also evaluated the quality of radiographs found all radiographs to be diagnostically acceptable.

Conclusion: The results confirm a reasonable use of methods to optimize radiation exposure and to maintain an optimal image quality of radiographs. A systematic review for each specific area in general radiography would be useful sometime in the future.