Analysis of the potential reasons for repeated radiography: a study in a major hospital in south eastern Iran

Abstract

Rejecting, removing and repeating the process of taking diagnostic X-ray images could lead to professional and moral challenges in the case of radiologic imaging. The aim of this study was to investigate the common causes of repetitive imaging and the types of images mostly repeated. Radiographs taken in our medical center form January 1st 2021 to July 1st 2021 were evaluated. After gathering information and importing form-related data into the statisti-cal software SPSS Ver. 26. In this study, a total of 4916 were evaluated. Among 398 repeated radiographs, 94 repetitions (23.62%) were due to inappropriate posi-tioning, 92 repetitions (23.12%) were due to patient’s movements, 56 repetitions (14.07%) were due to inadequate radiation, 51 repetitions (12.81%) were due to inadequate processing, 46 repetitions (11.56%) were due to inadequate preparation of the patient, and 59 repetitions (14.82 %) were due to other reasons. In this study, the rate of repeated radiographs taken in a tertiary hospital was estimated at 8.10%, with the most common cause for repetitions being inappropriate positioning. Considering the fact that repeated radiography mostly depends on operator-related factors, it is recommended to repeat the study after educating staff in order to compare the rate and reason of repetition. Introduction Rejecting, removing and repeating the radiology department, and finally reducing patients’ exposure to radiation.2 The radiographic examination is mostly done in at least two planes in order to gain diagnostic images to help diagnose disorders or dam-ages.3 A rejected image is one considered to have inadequate quality by a radiologist. The radiologist decides that the image does not hold technical standards for a certain diagnosis process and consequently rejects the image demanding another one.4 This recurrent imaging process increases the patient’s exposure to radiation and thus violates the concept of keeping ioniz-ing radiation exposure at a fair minimum. Moreover, rejected images reduce the efficiency of the department and patients’ consent which accordingly increases institu-tional costs.5 Evaluating the rate of repeated images is a part of the rejection analysis process, which is an acceptable standard to assure the quality in general radiology. Observing repeated radiographs can help evaluating the quality of diagnostic images, improving examination protocols, educating staff, and assessing patients’ radiation exposure.6,7 For a diagnostic radiology department to be able to provide images of high quality with the minimum exposure of patients and staff to the radiation, a program of quality assurance needs to be set and accomplished.8,9 The reasons for the rejection of images correspond with technical alternated advances. The most common reason to reject images in conventional film-screen radiology was reported to be exposure errors (that is, too much or too little exposure).10,11 Currently, this issue is a posi-tion error in computed radiography (CR) and digital radiology. The accuracy of results achieved by rejection analysis depends on radiologists’ obligation to cate-gorize their rejected images appropriately. Also, the ability of the imaging department to reduce the rate of rejected images depends on the application of findings acquired by rejection analysis using a feed-back and education system.12-15 This study reports the repetition rate in an imaging department in Iran. The aim of this study was to investigate the causes for repetitive imaging and to evaluate the types of images mostly repeated. r.