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Congress: ECR24
Poster Number: C-12424
Type: EPOS Radiographer (scientific)
DOI: 10.26044/ecr2024/C-12424
Authorblock: A. O'Sullivan, G. A. Curran, A. Smyth, M. F. Mcentee, A. England; Cork/IE
Disclosures:
Aisling O'Sullivan: Nothing to disclose
Gráinne Alison Curran: Nothing to disclose
Aine Smyth: Nothing to disclose
Mark F. Mcentee: Nothing to disclose
Andrew England: Board Member: EFRS Advisory Board: RoClub
Keywords: Musculoskeletal spine, Plain radiographic studies, Radiation safety, Quality assurance
Purpose Lumbar spine imaging is one of the procedures with the highest patient radiation dose.1 The possibility of dose reduction to the patient with the use of the posterior- anterior (PA) projection has been explored for a number of radiographic procedures.2-4 Over many years, several studies have noted that the radiation dose is reduced for postero-anterior (PA) projections of the lumbar spine when compared to antero-posterior (AP) projections (Fig. 1). Despite the abundance of research the AP remains the most widely...
Read more Methods and materials This systematic review was undertaken at University College Cork, Ireland and registered with PROSPERO (CRD42022377779). A comprehensive literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines5 in March 2023. Databases searched included; PubMed, the Cochrane Library, Google Scholar and Sciencedirect. Within the review, studies were deemed eligible for inclusion if they were peer-reviewed and published in English (Fig. 2). Studies could further be included if they included human participants and data from anthropomorphic...
Read more Results A total of seven studies were included in the qualitative synthesis (Fig. 3). These studies all met the search (inclusion/exclusion) criteria and directly compared lumbar spine radiography performed in the AP and PA positions. In total studies included 210 patients from both clinical and phantom experiments. All studies reported a lower effective dose for the PA projection when compared to the AP. Studies also agreed by consensus that there was no significant loss of image quality or diagnotic acceptability when...
Read more Conclusion The PA position for lumbar spine radiography has advantages over the AP position and has the potential to significantly reduce the radiation dose to the patient. There is a consensus in the literature that the PA position reduces the effective radiation dose to the patient and does not incur any statistically significant reductions in image quality. A remaining challenge is to the implement the findings of this systematic review into clinical practice, more research may be needed into how best...
Read more References European Union. Diagnostic Reference Levels in Thirty-six European Countries. Part 272.RadiatProt. 2014;180:173. https://ec.europa.eu/energy/sites/ener/files/documents/109_en.pdf.    Mc Entee MF, Kinsella C.. The PA projection of the clavicle: a dose-reducing technique. Radiat Prot Dosimetry. 2010;139:539–45. doi: 10.1093/rpd/ncp291   Mekis N, Mc Entee MF, Stegnar P.. PA positioning significantly reduces testicular dose during sacroiliac joint radiography. Radiography. 2010;16:333–8. doi: 10.1016/j.radi.2010.04.003.    Nic an Ghearr FA, Brennan PC.. The PA projection of the abdomen: A dose reducing technique. Radiography. 1998;4:195–203. doi: 10.1016/S1078-8174(98)80046-1. Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron,...
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