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

Hamid Dahmarde; Marzieh Abiri; Sharareh Sanei Sistani

doi:10.4081/hls.2023.10575

Authors

Hamid Dahmarde Deparment of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic Republic of.
Marzieh Abiri
30stana@gmail.com
Deparment of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic Republic of.
Sharareh Sanei Sistani Deparment of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic Republic of.

Introduction

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 reason for repetitive imaging and the types of images mostly repeated.

Methods

Radiographic images taken in this center in the first half of 1400 were evaluated. At the end of each week, repetitive images were referred to the researcher to analyze the frequency of repetitive radiographies and the causes.

Results

In this study, a total of 4916 radiographies taken in Ali Ibn-e-Abitibi Hospital during the first 6 months of the year 1400 were evaluated. Among 398 repetitive radiographies, 94 repetitions (23.62%) were due to inappropriate positioning, 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

Conclusion

In this study, the rate of repetitive radiographies taken in Ali Ibn-e-Abi Talib Hospital was estimated as 8.10%, with the most common reason for repetitions being estimated inappropriate positioning. Considering the fact that repetitive 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.

Hofmann B, Rosanowsky TB, Jensen C, Wah KHC. Image rejects in general direct digital radiography. Acta Radiol 2015;4:1–6. DOI: https://doi.org/10.1177/2058460115604339

Taylor N. The art of rejection: Comparative analysis between computed radiography (CR) and digital radiography (DR) workstations in the accident & emergency and general radiology departments at a district general hospital using customized and standardized reject criteria over a three year period. Radiography 2015;21:236–41. DOI: https://doi.org/10.1016/j.radi.2014.12.003

Atkinson S, Neep M, Starkey D. Reject rate analysis in digital radiography: an Australian emergency imaging department case study. J Med Radiat Sci 2020;67:72-9.

Jones AK, Polman R, Willis CE, Shepard SJ. One year’s results from a server-based system for performing reject analysis and exposure analysis in computed radiography. J Digit Imaging 2011;24:243–55. DOI: https://doi.org/10.1007/s10278-009-9236-2

Lin CS, Chan PC, Huang KH, et al. Guidelines for reducing image retakes of general digital radiography. Adv Mech Eng 2016;8:1–6. DOI: https://doi.org/10.1177/1687814016644127

Dunn MA, Rogers AT. X-ray film analysis as a quality indicator. Radiography 1998;4:3. DOI: https://doi.org/10.1016/S1078-8174(98)80027-8

Whaley JS, Pressman BD, Wilson JR, et al. Investigation of the variability in the assessment of digital chest X-ray image quality. J Digit Imaging 2013;26:217–26. DOI: https://doi.org/10.1007/s10278-012-9515-1

Alashban Y, Shubayr N, Alghamdi AA, et al. An assessment of image reject rates for digital radiography in Saudi Arabia: A cross-sectional study. J Radiation Res Appl Sci 2022;15:219-23.

Alyousef KA, Alkahtani S, Alessa R, Alruweili H. Radiograph reject analysis in a large tertiary care hospital in Riyadh, Saudi Arabia. Global J Qual Safety Healthc 2019;2:30-3. DOI: https://doi.org/10.4103/JQSH.JQSH_24_18

Nol J, Isouard G, Mirecki J. Digital repeat analysis; setup and operation. J Digit Imaging 2006;19:159–66. DOI: https://doi.org/10.1007/s10278-005-8733-1

Zhang M, Chu C. Optimization of the radiological protection of patients undergoing digital radiography. J Digit Imaging 2012;25:196–200. DOI: https://doi.org/10.1007/s10278-011-9395-9

Fintelmann F, Pulli B, Abedi-Tari F, et al. Repeat rates in digital chest radiography and strategies for improvement. J Thoracic Imag 2012;27:148-51. DOI: https://doi.org/10.1097/RTI.0b013e3182455f36

Zewdu M, Kadir E, Berhane M. Analysis and economic implication of X-Ray film reject in diagnostic radiology department of Jimma University Specialized Hospital, Southwest Ethiopia. Ethiopian J Health Sci 2017;27:421–6 DOI: https://doi.org/10.4314/ejhs.v27i4.13

Yurt A. Reject analysis in digital radiography: A prospective study. Int J Anat Radiol Surg 2018;7:4.

Owusu-Banahene J, Darko EO, Hasford F, et al. Film reject analysis and image quality in diagnostic Radiology Department of a Teaching hospital in Ghana. J Radiation Res Appl Sci 2014;7:589-94. DOI: https://doi.org/10.1016/j.jrras.2014.09.012

Haghparast M, Hosseini Tashnizi S, Golverdi Yazdi M, et al. Investigating the causes of repetition of radiographic images in radiology centers of Bandar Abbas teaching hospitals. Med J Hormozgan Univ 2013;17:74-167 (in Persian)

Fallah Mohammadi G, Samiei Z, Mirshafiei F. Digital radiography repeat rate and associated factors in referral hospitals, Sari, Iran 2017. J Mazandaran Univ Med Sci 2018;28:130-4.

Gourabi H, Sharafi A. Evaluation of repeated or abandonment of radiolgraphy in diagnostic radiology. Partou Journal 2003;1:12-14. [Persian]

Jadidi M. Quality assessment of the radiography films. Razi J Med Sci 2002;9:317-326. [Persian]

Asgharzadeh AA, Mohseni M. Evaluation of repeated radiographic film and its causes in Kashan hospitals in 2003. Feyz Journal 2005;33:50-56. [Persian] DOI: https://doi.org/10.1525/fq.2003.56.3.50

Atkinson S, Neep M, Starkey D. Reject rate analysis in digital radiography: an Australian emergency imaging department case study. J Med Radiat Sci 2020;67:72-9. DOI: https://doi.org/10.1002/jmrs.343

Alashban Y, Shubayr N, Alghamdi AA, et al. An assessment of image reject rates for digital radiography in Saudi Arabia: A cross-sectional study. J Radiat Res Appl Sci 2022;15:219-23. DOI: https://doi.org/10.1016/j.jrras.2022.01.023

Dahmarde, H., Abiri, M., & Sanei Sistani, S. (2023). Analysis of the potential reasons for repeated radiography: a study in a major hospital in south eastern Iran. Healthcare in Low-Resource Settings, 11(1). https://doi.org/10.4081/hls.2023.10575