Dr Craig Moore and Deborah Cook talk about a project to improve patient care in their Hospital Trust.
Objectives: The aim of this study was to investigate via simulation a proposed change to clinical practice for chest radiography. The validity of using an anti-scatter grid across the diagnostic energy range (60 – 125 kVp), in conjunction with appropriate tube current-time product (mAs) for imaging with a Computed Radiography (CR) system was investigated.
Methods: A digitally reconstructed radiograph algorithm was used which was capable of simulating CR chest radiographs with various tube voltages, receptor doses and scatter rejection methods. Four experienced image evaluators graded images with a grid (n = 80) at tube voltages across the diagnostic energy range and varying detector air kermas. These were scored against corresponding images reconstructed without a grid, as per current clinical protocol.
Results: For all patients, diagnostic image quality improved with the use of a grid, without the need to increase tube mAs (and therefore patient dose), irrespective of tube voltage used. Increasing tube mAs by an amount determined by the Bucky factor made little difference to image quality.
Conclusions: A virtual clinical trial has been performed with simulated chest CR images. Results indicate the use of a grid improves diagnostic image quality for average adults, without the need to increase tube mAs, even at low tube voltages.
Advances in knowledge: Validated with images containing realistic anatomical noise, it is possible to improve image quality by utilising grids for chest radiography with CR systems without increasing patient exposure. Increasing tube mAs by an amount determined by the Bucky factor is not justified.
Educational aim:
• To demonstrate that using anti-scatter grids with today’s digital imaging technology, no longer requires large increases in dose as it did with film-screen
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Speaker info
Craig Moore
Dr Craig Moore
Principal Physicist/ RPA/ MPE, Hull and East Yorkshire Hospitals NHS Trust
Dr Craig Moore is a practicing Medical Physics Expert and Radiation Protection Adviser at the Hull and East Yorkshire Hospitals NHS Trust. Routine duties include providing radiation safety advice and testing x-ray machines to ensure radiation dose and image quality is acceptable. His recent research interests have focussed around patient dose and image quality optimisation leading to optimised radiation dose settings for chest radiography across the Trust. One recent change in practice, as a direct result of his research, has potentially resulted in improved care for 1000s of patients per year. Other interests include optimising dose on the Trust’s CT scanners, radiotherapy imaging machines and breast screening mammography machines. He has published nearly 20 peer reviewed papers in respected journals.