Keywords:
Quality assurance, Kv imaging, Education and training, Radiation safety, Radiation effects, Education, Digital radiography, Conventional radiography, Radioprotection / Radiation dose, Professional issues, Paediatric
Authors:
G. NG1, D. Tse1, V. Lee1, Y.-L. Li1, M. CHEUNG2, L. CHIN1, S. Lau1, W. M. W. Lam1, P. W. T. Lam1; 1Department of Radiology, Queen Mary Hospital/HK, 2Hong Kong/HK
DOI:
10.26044/ecr2019/C-1836
Methods and materials
Retrospective data collection of all pelvic,
hip and scoliosis radiography performed in our hospital from September 2017 to March 2018,
for patients under 18 years of age are included.
Radiographs performed as part of major trauma series are excluded from the study.
Using the ICRP publication 121: Radiological Protection in Paediatric Diagnostic and Interventional Radiology as the reference standard,
the radiographs were reviewed by a paediatric radiologist.
For each examination,
the image is assessed to determine 1) the presence or absence of gonad protection,
and 2) whether the protection was placed correctly (Figure 1):
- The protection should not obscure any bony anatomy
- Shielding of gonads was considered adequate if the area covered by the shield protects the traditionally expected location of reproductive organs.
In males,
this was defined as covering the soft tissue margins of the scrotum inferiorly to the symphysis pubis.
In females,
the pelvic basin was used as popular gonad shield designs presume the ovaries to lie within the pelvic basin.
Shielding 100% of the pelvic basin without obstructing any bony anatomy would require unrealistically tight precision of shield placement.
Therefore a subjective estimate was made and coverage was deemed adequate if about 90% of the pelvic basin was protected.
- For scoliosis imaging performed to assess curve progression,
shielding of gonads was considered adequate in female patients if 90% of the pelvic basin was protected,
even though partially the lower pelvic bone including pubic symphysis may be obscured,
since these bony anatomy are not essential for follow up curve assessment.
The criteria for male scoliosis radiography remains the same as (2).
Our target is at least 90% of cases with gonad protection present,
with at least 90% of these cases showed correct placement of protection.
In case these targets were not met during the period,
we analyzed the underlying reasons and implemented changes,
in hopes to improve the performance in the re-audit cycle,
which was conducted in June 2018 to September 2018.