Assessment of image rejection in digital radiography

J Med Life. 2023 May;16(5):731-735. doi: 10.25122/jml-2022-0341.

Abstract

X-ray imaging uses ionizing radiation to generate diagnostic images. However, unnecessary radiation exposure can pose potential risks, including an increased risk of malignancy. One factor contributing to unnecessary radiation exposure is the rejection and retaking of X-ray images, which can lead to higher patient and occupational radiation doses. This study aimed to assess digital radiography rejection rates, causes of recurrence, and the most commonly repeated types of examinations. A cross-sectional online-based survey was conducted in 2022, involving 62 randomly selected radiographers in the UAE. The survey was distributed to radiographers through the head of radiology departments in various hospitals. Hospitals agreed to participate in the survey without disclosing their name. The data collected was analyzed using Excel. The study showed that 71% of radiographers working in the UAE hold a bachelor's degree. The examinations most frequently repeated were related to anatomical areas, with the spine accounting for 37.7% and facial bone for 19.7% of cases. The factors influencing repetition were primarily related to positioning (48.4%) and artifacts (21%), with the motion being the main cause of artifacts, including voluntary and involuntary movements. This study concluded that the most prevalent cause of repeating and retaking images is positioning, followed by artifacts. Furthermore, night shifts and workload impact radiographer performance, increasing the likelihood of picture retakes. The average number of rejects and repeated images has been reduced as new generations and modern equipment have been introduced, which also helped decrease the numbers.

Keywords: ionizing radiation; medical imaging; reject analysis.