Lumbar spine radiography is classified as a relatively high dose examination which irradiates the radiosensitive reproductive organs of both males and females. Radiographic imaging of the lumbar spine accounts for 2.1% of all conventional X-ray examinations and 2.2% of the collective dose within the United Kingdom (UK) (Hart et al., 2010). One simple but effective method of radiation dose reduction is the replacement of the traditionally performed anteroposterior (AP) projection with the posteroanterior (PA) projection.Despite this it is still common practice for the majority of...

Imaging equipment and phantom The study was conducted in a university imaging department using a Wolverson Acroma X-Ray unit (Wolverson X-ray Ltd, Willenhall, UK) with a Varian 130 HS X-ray tube (Varian Medical Systems, Palo Alto, CA) with an inherent filtration of 3 mm aluminium. An Agfa (Agfa-Gevaert, Mortsel, Belgium) 35 x 43 cm computed radiography (CR) image receptor was used for acquisition and images were processed using an Agfa CR 35-X digitiser. All exposures included the use of a 10:1 reciprocating grid with (40...

Image quality Total (weighted) image quality scores for both the AP and PA projections, for each kVp increment, are presented in Table 1and Figure 1. An image quality score of 48 was considered equal to the reference image after weighting factors were applied. Table 1. Image quality scores for the AP and PA projection. kVp AP Projection PA Projection Mean SD % change from reference Mean SD % change from reference 75 41.6 1.1 -13.3 80 58.2 5.8 +21.3 45.4 5.8 -5.4 85 52.4 7.7...

Results obtained in this investigation demonstrate that the PA projection dramatically reduces the effective dose (up to 20%), and absorbed doses to the stomach (70.4%), colon (61.1%), remainder tissues (33.2%), ovaries (7.3%) and testes (15.9%), when compared to the AP projection. This may be at the expense of a minor reduction in image quality (not statistically significant). This may further be considered acceptable when balanced against the significant dose reduction and, therefore, despite this the PA projection may be considered as the preferred option when...

Enda Davey is a Band 5 Radiographer at Salford Royal Hospitals NHS Foundation Trust, Manchester, UK. Enda was formerly a student at the University of Salford where this research was undertaken. Andrew England ([email protected]) is a Senior Lecturer at the University of Salford, Manchester, UK and was research supervisor for this project. Research was conducted has part of the University of Salford Diagnostic Imaging Research Programme (DIRP).

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