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Clinical Review of Radiography Reject and Repeat Rate Changes After Upgrading From CR to DR

R Fisher1*, (1) MetroHealth, Cleveland, OH


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: Digital radiographic panels allow technologists to immediately see an exposure without the processing delays associated with CR imaging. It was hypothesized that this immediate feedback could lead to increases in rejected and repeated images in clinical practice. The purpose of this work was to investigate any changes in repeat and reject rate for radiographic images in an outpatient imaging setting after a switch from CR to DR imaging.

Methods: Two radiographic rooms were upgraded from CR to DR image receptors, with the x-ray equipment and staff remaining unchanged. The number of repeated and rejected images were examined for a period of three months before and after the switch. Overall and exam specific repeat and reject rates were calculated to evaluate any impact the DR technology had on clinical practice.

Results: The facility overall rejected image rate increased from 6.1% with CR to 8.5% with DR, an increase of 40%. Similarly, the repeated image rate increased from 5.2% to 7.7%, for an increase of 49%. Investigation into specific exams showed that rates for various upper and lower extremity exams increased greatly after the switch, with some growing by over 200%. Both repeat and reject rates for AP Abdomen and 2 view chest exams increased on the order of 60%.

Conclusion: Overall repeat and reject rates were found to increase after a switch from CR to DR. Upper and lower extremity exams drove most of the increase, with chest and abdominal imaging also contributing. The clinical diagnostic impact of these increases remains unknown. Increased repeat rates could indicate technologists are repeating images to cover clipped anatomy, ensuring adequate anatomical coverage for an exam. It is also possible that otherwise “good enough” images are being rejected in favor of better positioned ones as a result of the immediate image feedback.


Radiography, Quality Assurance, Quality Control


IM- X-Ray: Quality Control and Image Quality Assessment

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