Рентгенология & Радиология, 2015, LIV 227-236

Survey of practice in paediatric chest radiography. Part 1
D. Kostova-Lefterova

The purpose of this work is to assess the current practice in paediatric chest radiography for a selected number of x-ray departments, using standardized questionnaires and forms for recording and analysing the patient data, exposure parameters and dose. The results are compared with the existing good practice in pediatric chest radiography. Some opportunities for optimization and reduction of the dose are shown. The study of pediatric radiography practice and patient
doses was conducted for four X-ray units in four different hospitals in Sofia (Bulgaria). A total number of 269 chest X-ray examinations (AP and PA projection) are included, for children aged from 0 to 15 years. It was found lack of standardization in the radiography practice and the routine protocols used for conventional radiography of children of the same age group, also between the different X-ray departments and even between the radiographers working with the same X-ray unit. There is no correlation between the selected exposure  parameters and patient age or weight. The most common errors are: not justified used of AP projection; inappropriate use of the anti-scatter grid even for children under 5 years.; use of inappropriate film size (image detector size) and insufficient beam collimation; use of too low tube voltage and a longer exposure time than the recommended; no lead shielding used to reduce dose to radiosensitive organs; all three chambers of automatic exposure control are selected in the majority of patients, while for the others – both two lateral chambers used, regardless of the age of the pediatric patients.