Technique, radiation safety and image quality for chest X-ray imaging through glass and in mobile settings during the CO
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Technique, radiation safety and image quality for chest X‑ray imaging through glass and in mobile settings during the COVID‑19 pandemic Zoe Brady1,2 · Heather Scoullar1 · Ben Grinsted1 · Kyle Ewert1 · Helen Kavnoudias1,2,3 · Alexander Jarema1 · James Crocker1 · Rob Wills1 · Gillian Houston1 · Meng Law1,2,4 · Dinesh Varma1,3 Received: 3 July 2020 / Accepted: 4 July 2020 © Australasian College of Physical Scientists and Engineers in Medicine 2020
Abstract The COVID-19 pandemic in 2020 has led to preparations within our hospital for an expected surge of patients. This included developing a technique to perform mobile chest X-ray imaging through glass, allowing the X-ray unit to remain outside of the patient’s room, effectively reducing the cleaning time associated with disinfecting equipment. The technique also reduced the infection risk of radiographers. We assessed the attenuation of different types of glass in the hospital and the technique parameters required to account for the glass filtration and additional source to image distance (SID). Radiation measurements were undertaken in a simulated set-up to determine the appropriate position for staff inside and outside the room to ensure occupational doses were kept as low as reasonably achievable. Image quality was scored and technical parameter information collated. The alternative to imaging through glass is the standard portable chest X-ray within the room. The radiation safety requirements for this standard technique were also assessed. Image quality was found to be acceptable or borderline in 90% of the images taken through glass and the average patient dose was 0.02 millisieverts (mSv) per image. The majority (67%) of images were acquired at 110 kV, with an average 5.5 mAs and with SID ranging from 180 to 300 cm. With staff positioned at greater than 1 m from the patient and at more than 1 m laterally from the tube head outside the room to minimise scatter exposure, air kerma values did not exceed 0.5 microgray (µGy) per image. This method has been implemented successfully. Keywords Chest imaging · X-ray · Pandemic · Radiation safety · Portable · COVID-19
Introduction The World Health Organisation (WHO) classified the spread of the SARS-CoV-2 (COVID-19) virus as a pandemic on 11 March 2020 [1]. In Australia (population over 25 million), there are approximately 7500 cases of COVID-19 and 100 related deaths [2]. As of June 2020, Australia has been relatively spared from uncontrolled spread of the disease compared with international infection rates and only 10% * Zoe Brady [email protected] 1
Radiology Department, Alfred Health, Melbourne, VIC, Australia
2
Department of Neuroscience, Monash University, Melbourne, VIC, Australia
3
Department of Surgery, Monash University, Melbourne, VIC, Australia
4
Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
of cases acquired within Australia are from unknown transmission of the virus [2]. The isolation and social distancing m
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