Theme
Radiologic Technology
INSTITUTION
King Abdulaziz Medical City
King Abdulaziz Medical City (KAMC) is a large tertiary care hospital in Riyadh, Saudi Arabia with a bed capacity of 1500. There is currently lack of sufficient reported data of reject analysis in Kingdom of Saudi Arabia. This study is the first of its kind and scale to be conducted at KAMC. The results of this study helps to improve radiological services and reduce the unnecessary radiation exposure to the patients.
In our study, we have identified that the most common reason for rejection is labeling which constitute 22%. Based on American Association of Physicists in Medicine, the variation in rejection showed a factor of three between different types of hospitals. The factor of three has been demonstrated in positioning between KAMC and David H. Foos et al. (Table1). Exposure factor error in David H. Foos et al. have comparable results with our study due to the utilization of digital systems which have extended dynamic range. In contrary, Nasrollah Jabbari et al. shows a significant rejection of exposure factor due to the limited exposure latitude (Table1).
Table 1. Rejected Radiographs by Reason for Rejection |
||||
|
KAMC |
David H. Foos et al.* |
David H. Foos et al.** |
Nasrollah Jabbari et al.*** |
Positioning |
14% |
56% |
45% |
17% |
Artifacts |
13% |
7% |
11% |
9% |
Exposure Factor |
6% |
13% |
14% |
54% |
* University hospital ** Community hospital *** University hospital Using analog system |
In terms of body parts, more than (70%) of the rejected radiographs were either for extremities or chest (Table2).
Table 2. Rejected Radiographs by Body Part |
||||
|
KAMC |
David H. Foos et al.* |
David H. Foos et al.** |
Nasrollah Jabbari et al.*** |
Extremities |
43% |
37% |
22% |
31% |
Chest |
31% |
29% |
45% |
34% |
Abdomen |
9% |
6% |
8% |
4% |
Spine |
8% |
15% |
16% |
17% |
Pelvis |
5% |
12% |
7% |
4% |
Head and Neck |
4% |
1% |
2% |
10% |
Total |
100% |
100% |
100% |
100% |
* University hospital ** Community hospital *** University hospital Using analog system |
The comparison of KAMC and Nasrollah Jabbari et al. with age group distribution is shown in (Table.3).
Table 3. Rejected Radiographs by Age Group |
||
|
KAMC |
Nasrollah Jabbari et al.*** |
Adult |
60% |
83% |
Pediatric |
40% |
17% |
Total |
100% |
100% |
KAMC compromises a dedicated specialized children hospital *** University hospital Using analog system |
Radiographs reject analysis has been used to investigate the quality of radiographic examinations in KAMC Radiology department. Based on AAPM recommendation, rejection should be collected and analyzed on at least a quarterly basis, but preferably monthly. Also, it is recommended to have training sessions quarterly or monthly for the technologist. Results of the analysis of the rejection can be utilized to plan for training programs and continuous education and used as a base line for need assessment.