England, A ORCID: https://orcid.org/0000-0001-6333-7776, Littler, E, Romani, S and Cosson, P (2021) Modifications to mobile chest radiography technique during the COVID-19 pandemic – implications of X-raying through side room windows. Radiography, 27 (1). pp. 193-199.

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Abstract

Introduction
Modifications to common radiographic techniques have resulted from the challenges presented by the COVID-19 pandemic. Reports exist regarding the potential benefits of undertaking mobile radiography through side room windows. The aim of this study was to evaluate the impact on image quality and exposure factors when undertaking such examinations.

Methods
A phantom based study was undertaken using a digital X-ray room. Control acquisitions, using a commercially available image quality test tool, were performed using standard mobile chest radiography acquisition factors. Image quality (physical and visual), incidence surface air kerma (ISAK), Exposure Index (EI) and Deviation Index (DI) were recorded. Image quality and radiation dose were further assessed for two additional (experimental) scenarios, where a side room window was located immediately adjacent to the exit port of the light beam diaphragm. The goal of experimental scenario one was to modify exposure factors to maintain the control ISAK. The goal of experimental scenario two was to modify exposure factors to maintain the control EI and DI. Dose and image quality data were compared between the three scenarios.

Results
To maintain the pre-window (control) ISAK (76 μGy), tube output needed a three-fold increase (90 kV/4 mAs versus 90 kV/11.25 mAs). To maintain EI/DI a more modest increase in tube output was required (90 kV/8 mAs/ISAK 54 μGy). Physical and visual assessments of spatial resolution and signal-to-noise ratio were indifferent between the three scenarios. There was a slight statistically significant reduction in contrast-to-noise ratio when imaging through the glass window (2.3 versus 1.4 and 1.2; P = 0.005).

Conclusion
Undertaking mobile X-ray examinations through side room windows is potentially feasible but does require an increase in tube output and is likely to be limited by minor reductions in image quality.

Item Type: Article
Additional Information: The final version of this accepted manuscript is available online at https://www.sciencedirect.com/science/article/pii/S1078817420301395
Uncontrolled Keywords: COVID-19; Mobile radiography; Modified technique; Image quality; Radiation dose
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 25 Aug 2020 13:27
Last Modified: 03 Aug 2021 01:30
URI: https://eprints.keele.ac.uk/id/eprint/8582

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