Comparison of conventional and through glass portable chest computed radiography: A Phantom study

Main Article Content

Kingkarn Aphiwatthanasumet

Abstract

Background: Since the outbreak of COVID-19, modified hospital unit or area for chest radiography of positive cases have become necessary. To date, relatively few studies have been investigated on the effects of portable chest radiography through glass barrier.


Objectives: Our goal was to evaluate exposure technique and radiation dose between conventional and through glass portable chest computed radiography.


Materials and methods: Experiments using an anthropomorphic phantom were performed for acquired portable chest PA radiography at SID 180 cm with glass door being open and closed. The EI and DI values were optimized to provide the appropriate exposure technique for glass barrier. Entrance surface air kerma and scatter survey were made to assess the radiation dose both inside and outside the room. Finally, HVL measurement of primary X-ray beam and after transmission through glass were determined.


Results: Based on the fixed kVp and mAs technique, the EI value with glass barrier was less than the EI without the glass. Imaging through glass barrier showed the average EI reduction of 10.4% for Carestream and 37% for Konica. The average entrance surface air kerma reduction was 56.6% over a range of 90-120 kVp. The appropriate exposure technique for conventional portable chest PA using computed radiography was 100 kVp 2.5 mAs. With the same kVp setting, doubling the mAs is required for imaging through glass barrier to produce good diagnostic image quality (100 kVp and 4.0 mAs). The acceptable EI and DI ranges for CR used were EI=1742, DI=-0.02 (without glass) and EI=1795, DI=0.11 (with glass) for Carestream and EI=352, DI=-0.03 (without glass) and EI=373, DI=0.22 (with glass) for Konica respectively. The primary beam after transmission through the glass thickness 5 mm was 36%. The measured scatter of inside room compared to outside was very low at 1-2 meters. Increasing od HVL from 3.9 to 6.1 mm Al indicates the effect of beam hardening by glass.


Conclusion: These experiments confirmed that through glass portable chest computed radiography are feasible and safe. The findings of this study have several practical implications which minimizes risk to radiographers during their work.

Article Details

How to Cite
Aphiwatthanasumet, K. (2022). Comparison of conventional and through glass portable chest computed radiography: A Phantom study. Journal of Associated Medical Sciences, 55(2), 1–9. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/253224
Section
Research Articles

References

Mossa-Basha M, Medverd J, Linnau KF, Lynch JB, Wener MH, Kicska G, et al. Policies and guidelines for COVID-19 preparedness: experiences from the University of Washington. Radiology. 2020; 296(2): E26-E31.

Goyal A, Tiwari R, Bagarhatta M, Ashwini B, Rathi B, Bhandari S. Role of portable chest radiography in management of COVID-19: Experience of 422 patients from a tertiary care center in India. The Indian Journal of Radiology & Imaging. 2021; 31(Suppl 1): S94.

Chamorro EM, Tascón AD, Sanz LI, Vélez SO, Nacenta SB. Radiologic diagnosis of patients with COVID-19. Radiología (English Edition). 2021; 63(1): 56-73.

Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clinical imaging. 2020; 64: 35-42.

Jain A, Patankar S, Kale S, Bairy A. Imaging of coronavirus disease (COVID-19): a pictorial review. Polish Journal of Radiology. 2021; 86: e4.

Akudjedu TN, Mishio NA, Elshami W, Culp MP, Lawal O, Botwe BO, et al. The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning.

Radiography. 2021; 27(4): 1219-26.

Niu Y, Xian J, Lei Z, Liu X, Sun Q. Management of infection control and radiological protection in diagnostic radiology examination of COVID-19 cases. Radiation medicine and protection. 2020; 1(02): 75-80.

Moirano JM, Dunnam JS, Zamora DA, Robinson JD, Medverd JR, Kanal KM. Through-the-Glass Portable Radiography of Patients in Isolation Units: Experience During the COVID-19 Pandemic. AJR Am J Roentgenol. 2021: 883-7.

Brady Z, Scoullar H, Grinsted B, Ewert K, Kavnoudias H, Jarema A, et al. Technique, radiation safety and image quality for chest X-ray imaging through glass and in mobile settings during the COVID-19 pandemic. Physical and engineering sciences in medicine. 2020; 43(3): 765-79.

Gange CP, Pahade JK, Cortopassi I, Bader AS, Bokhari J, Hoerner M, et al. Social Distancing with Portable Chest Radiographs During the COVID-19 Pandemic: Assessment of Radiograph Technique and Image Quality Obtained at 6 Feet and Through Glass. Radiology: Cardiothoracic Imaging. 2020; 2(6): e200420.

Sng LH, Arlany L, Toh LC, Loo T, Ilzam N, Wong B, et al. Initial data from an experiment to implement a safe procedure to perform PA erect chest radiographs for COVID-19 patients with a mobile radiographic system in a “clean” zone of the hospital ward. Radiography. 2021; 27(1): 48-53.

Medicine AAoPi. Quality control in diagnostic radiology. AAPM Report. 2002; 74.

Seibert JA, Bogucki TM, Ciona T, Huda W, Karellas A, Mercier J, et al. Acceptance testing and quality control of photostimulable storage phosphor imaging systems. Rpt of AAPM Task Group. 2006(10).

Dave JK, Jones AK, Fisher R, Hulme K, Rill L, Zamora D, et al. Current state of practice regarding digital radiography exposure indicators and deviation indices: Report of AAPM Imaging Physics Committee Task Group 232. Medical physics. 2018; 45(11): e1146-e60.

Protection ICoR. Diagnostic reference levels in medical imaging: review and additional advice. Ann ICRP. 2001; 31(4): 33-52.

Lorusso JR, Fitzgeorge L, Lorusso D, Lorusso E. Examining Practitioners' Assessments of Perceived Aesthetic and Diagnostic Quality of High kVp–Low mAs Pelvis, Chest, Skull, and Hand Phantom Radiographs. Journal of medical imaging and radiation sciences. 2015; 46(2): 162-73.

Liu TY, Rai A, Ditkofsky N, Deva DP, Dowdell TR, Ackery AD, et al. Cost benefit analysis of portable chest radiography through glass: Initial experience at a tertiary care centre during COVID-19 pandemic. Journal of Medical Imaging and Radiation Sciences. 2021.

McKenney SE, Wait JM, Cooper III VN, Johnson AM, Wang J, Leung AN, et al. Multi‐institution consensus paper for acquisition of portable chest radiographs through glass barriers. Journal of applied clinical medical physics. 2021; 22(8): 219-29.

Chan J, Auffermann W, Jenkins P, Streitmatter S, Duong P-A. Implementing a novel through-glass chest radiography technique for COVID-19 patients: image quality, radiation dose optimization, and practical considerations. Current Problems in Diagnostic Radiology. 2022; 51(1): 38-45.

Rai A, MacGregor K, Hunt B, Gontar A, Ditkofsky N, Deva D, et al. Proof of concept: phantom study to ensure quality and safety of portable chest radiography through glass during the COVID-19 pandemic. Investigative radiology. 2021; 56(3): 135-40.

Cho J, Lee S, Gu BS, Jung SH, Kim HY. The Impact of COVID-19 on the Use of Radiology Resources in a Tertiary Hospital. Journal of Korean Medical Science. 2020; 35(40).

Le N, Sorensen J, Bui T, Choudhary A, Luu K, Nguyen H. Enhance Portable Radiograph for Fast and High Accurate COVID-19 Monitoring. Diagnostics. 2021; 11(6): 1080.

Hussain L, Nguyen T, Li H, Abbasi AA, Lone KJ, Zhao Z, et al. Machine-learning classification of texture features of portable chest X-ray accurately classifies COVID-19 lung infection. BioMedical Engineering OnLine. 2020; 19(1): 1-18.

Kikkisetti S, Zhu J, Shen B, Li H, Duong TQ. Deep-learning convolutional neural networks with transfer learning accurately classify COVID-19 lung infection on portable chest radiographs. PeerJ. 2020; 8: e10309.

Basu S, Mitra S, Saha N, editors. Deep learning for screening covid-19 using chest x-ray images. 2020 IEEE Symposium Series on Computational Intelligence (SSCI); 2020: IEEE.

Zhu J, Shen B, Abbasi A, Hoshmand-Kochi M, Li H, Duong TQ. Deep transfer learning artificial intelligence accurately stages COVID-19 lung disease severity on portable chest radiographs. PloS one. 2020; 15(7): e0236621