Assessment of X-ray films and image quality in diagnostic radiology departments of teaching hospitals in Iraq

Background: Patients undergo repeated X-ray examinations after their initial X-ray radiographs are rejected due to poor image quality. Reject analysis in digital radiography (CR) helps guide the education and training of staff, influences department workflow, reduces patient dose and improves department efficiency. The role of reject analysis in providing relevant information that would help achieve a sound reduction in radiation exposure.Aims:To assess the reasons for X-ray film rejection and to analyze reasons for deletions to improve the radiological services.Methods: The data were collected from about 200 rejected films from different hospitals in Iraq from January 2021 to August 2021. The reject rate, reasons for rejection for individual radiographers, examination types and projections used a structured format on which investigators recorded relevant data for rejection. The results were then collected and entered into a database for analysis.Results: Reject rate and cause of rejection were measured across all plane X-ray examinations for the hospitals in Kirkuk General Hospital at 8.1%, Mosul General Hospital at 13.9% and Al-Jumhory Hospital at 6.4%. Study cases and (appointment) 16.1%, Mass & Kv with positioning error 3.7%. The examinations with the highest percentage of deleted images were the chest, lumber spine & knee joints, 13.2%, 3.2% and 1.7%, respectively.Conclusions: Creating awareness among the student reduces the overall reject rate. The outcome of this study can be used to set up training programs to improve radiological services and reduce unnecessary radiation exposure to patients.

Automated summary

This study aimed to evaluate the reasons for X-ray film rejection and analyze the reasons for deletions in order to improve radiological services. Data were collected from about 200 rejected films from different hospitals in Iraq, recording reject rate, reasons for rejection by individual radiographers, examination types, and projections. The results showed that the reject rates were 8.1% in Kirkuk General Hospital, 13.9% in Mosul General Hospital, and 6.4% in Al-Jumhory Hospital. Study cases and (appointment) accounted for 16.1%, while mass & Kv with positioning error accounted for 3.7%. The examinations with the highest percentage of deleted images were the chest, lumber spine, and knee joints, accounting for 13.2%, 3.2%, and 1.7%, respectively.