Comparative analysis of radiation dose and low contrast detail detectability using routine paediatric chest radiography protocols

Objectives: To compare low contrast detail (LCD) detectability and radiation dose for routine paediatric chest X-ray (CXR) imaging protocols among various hospitals. Methods: CDRAD 2.0 phantom and medical grade polymethyl methacrylate (PMMA) slabs were used to simulate the chest region of four different paediatric age groups. Radiographic acquisitions were undertaken on 17 X-ray machines located in eight hospitals using their existing CXR protocols. LCD detectability represented by image quality figure inverse (IQF _inv ) was measured physically using the CDRAD analyser software. Incident air kerma (IAK) measurements were obtained using a solid-state dosimeter. Results: The range of IQF _inv , between and within the hospitals, was 1.40–4.44 and 1.52–2.18, respectively for neonates; 0.96–4.73 and 2.33–4.73 for a 1-year old; 0.87–1.81 and 0.98–1.46 for a 5-year old and 0.90–2.39 and 1.27–2.39 for a 10-year old. The range of IAK, between and within the hospitals, was 8.56–52.62 μGy and 21.79–52.62 μGy, respectively for neonates; 5.44–82.82 μGy and 36.78–82.82 μGy for a 1-year old; 10.97–59.22 μGy and 11.75–52.94 μGy for a 5-year old and 13.97–100.77 μGy and 35.72–100.77 μGy for a 10-year old. Conclusions: Results show considerable variation, between and within hospitals, in the LCD detectability and IAK. Further radiation dose optimisation for the four paediatric age groups, especially in hospitals /X-ray rooms with low LCD detectability and high IAK, are required.