Journal List > Prog Med Phys > v.24(2) > 1098377

Kim, Sung, Kim, Shin, Lee, Jung, Uhm, Lee, Seong, Kim, and Kim: Nationwise Survey of the X-ray Beam Collimator Utilization in General Diagnostic Radiograph

Abstract

Due to the introduction of CR and DR, it has been neglected the use of the X-ray beam collimator and field size. This study examines nationwide survey of the proper use of collimator and field size by area in a specific field of plain radiography and the current status. Authors emphasized the need for the field size criteria, and propose a standard reference field size in each specific radiologic examination. Total 333 medical institutions (included in Seoul, Gyeonggi-do, Jeolla, Chungcheong, Gangwon-do, Busan area), were investigated in relation to the status of the X-ray beam collimation field size, type specific inspection areas, medical facilities, and image analyses by type to figure out whether they use the adjustment of image field to the specific examination. To assess the awareness and the impact of radiation exposure to the collimation adjustable, 168 radiographers who was working in 10 general hospitals, 10 hospitals, and 10 clinics, were surveyed how they haver adjusted the actual field size. We examine that 61.3% of medical institutions used the “Proper collimation” and only 49.9% of them employed proper one in lumbar spine densely crowded by major organs. 69% among general hospitals, and 65% among hospitals using DR system were using proper collimation. Radiographers recognized that proper adjustment of collimation could reduce the harmful radiation dose on patients. In the survey, 97.6% of respondents were aware of this fact, but only 83.3% of respondents did the adjustment of the size of the collimation field. The using of proper collimation field was low in the nationwide survey, so the effort to reduce the radiation dose on the patients is urgently needed. A unified standard for the field accompanied by thorough education should be needed.

REFERENCES

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Table 1.
Questionnaire for the use of X-ray beam collimation.
pmp-24-119t1.tif
Table 2.
X-ray beam collimation for different body regions (total).
Adequate collimation Poor collimation Total
Partly using Full open
204 (61.3%) 43 (12.9%) 86 (25.8%) 333 (100%)
Table 3.
X-ray beam collimation for medical institutions.
Medical institution Adequate collimation (%) Poor collimation Total (%)
Partly using (%) Full open (%)
Clinic 39 (56.5) 10 (14.5) 20 (29.0) 69 (100)
Hospital 76 (56.3) 20 (14.8) 39 (28.9) 135 (100)
General hospital 89 (69.0) 13 (10.1) 27 (20.9) 129 (100)
Table 4.
X-ray beam collimation for kind of image.
Kind of image Adequate collimation (%) Poor collimation Total (%)
Partly using (%) Full open (%)
Film 35 (67.3) 4 (7.7) 13 (25.0) 52 (100%)
CR 93 (56.7) 24 (14.6) 47 (28.7) 164 (100%)
DR 76 (65.0) 15 (12.8) 26 (22.2) 117 (100%)
Table 5.
X-ray beam collimation for different body regions
Radiographic exam. Adequate (%) Poor (%)
Chest PA 333 (100) 0 (0)
Chest Lat 333 (100) 0 (0)
Abdomen AP 333 (100) 0 (0)
Pelvis AP 333 (100) 0 (0)
Wrist AP 196 (59.0) 137 (41.0)
Elbow AP 218 (65.5) 115 (34.5)
Humerus AP 215 (64.6) 118 (35.4)
Shoulder AP 237 (71.2) 96 (28.8)
Hip AP 333 (100) 0 (0)
Knee AP 220 (66.1) 113 (33.9)
Ankle AP 218 (65.5) 115 (34.5)
Skull AP 240 (72.1) 93 (27.9)
Skull Lat 240 (72.1) 93 (27.9)
C-Spine AP 238 (71.5) 95 (28.5)
C-Spine Lat 238 (71.5) 95 (28.5)
B) Clavicle AP 193 (58.0) 140 (42.0)
T-Spine AP 149 (44.8) 184 (55.2)
T-Spine Lat 148 (44.5) 185 (55.5)
L-Spine AP 189 (56.8) 144 (43.2)
L-Spine Lat 172 (51.7) 161 (48.3)
Table 6.
Status of X-ray beam collimation size in clinical examinations.
Radiographic exam. Adequate collimation (%) Poor collimation (%)
Wrist AP 106 (63.1) 62 (36.9)
Elbow AP 168 (100) 0 (0)
Humerus AP 116 (69.0) 52 (31.0)
Ankle AP 168 (100) 0 (0)
Knee AP 154 (91.7) 14 (8.3)
Skull AP 168 (100) 0 (0)
C-spine AP 168 (100) 0 (0)
B) clavicle AP 168 (100) 0 (0)
Shoulder AP 164 (97.6) 4 (2.4)
T-spine AP 117 (69.6) 51 (30.4)
T-spine Lat 121 (78.0) 47 (28.0)
L-spine AP 95 (56.9) 72 (43.1)
L-spine Lat 118 (70.7) 49 (29.3)
Table 7.
Difference of inadequate rate between clinical and document survey.
Radiographic exam.  Inadequate rate in clinical survey (%) Inadequate rate in document survery (%)
Wrist AP 41 36.9
Elbow AP 34.5 0
Humerus AP 35.4 31
Ankle AP 34.5 0
Knee AP 33.9 8.3
Skull AP 27.9 0
C-spine AP 28.5 0
B) clavicle AP 42 0
Shoulder AP 28.8 2.4
T-spine AP 55.2 30.4
L-spine AP 43.2 43.1
T-spine Lat 55.5 28
L-spine Lat 48.3 29.3
Table 8.
Standard X-ray beam collimation size in radiographic examinations.
Radiographic exam. X-ray beam collimation size (inch)
Wrist Elbow AP AP 8×10 10×12
Humerus AP 7×17
Ankle AP 8×10
Knee AP 10×12 or 7×17
Skull C-Spine AP AP 10×12 8×10 or 10×12
B) Clavicle AP 7×17 or 14×17
Shoulder AP 10×12
Chest PA 14×14 or 14×17
Abdomen AP 14×17
Pelvis AP 14×17
Hip AP 14×17
T-Spine AP 7×17
L-Spine AP 7×17
T-Spine LAT 11×14
L-Spine L-Spine LAT OBL 11×14 11×14
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