Rationale and Objectives
The purpose of this study was to develop and evaluate a patient thickness-based protocol
specifically for the confirmation of enteric tube placements in bedside abdominal
radiographs. Protocol techniques were set to maintain image quality while minimizing
patient dose.
Materials and Methods
A total of 226 pre-intervention radiographs were obtained to serve as a baseline cohort
for comparison. After the implementation of a thickness-based protocol, a total of
229 radiographs were obtained as part of an intervention cohort. Radiographs were
randomized and graded for diagnostic quality by seven expert radiologists based on
a standardized conspicuity scale (grades: 0 non-diagnostic to 3+). Basic patient demographics,
body mass index, ventilatory status, and enteric tube type were recorded and subgroup
analyses were performed. Effective dose was estimated for both cohorts.
Results
The dedicated thickness-based protocol resulted in a significant reduction in effective
dose of 80% (p-value < 0.01). There was no significant difference in diagnostic quality between
the two cohorts with 209 (92.5%) diagnostic radiographs in the baseline and 221 (96.5%)
diagnostic radiographs in the thickness-based protocol (p-value 0.06).
Conclusion
A protocol optimized for the confirmation of enteric tube placements was developed.
This protocol results in lower patient effective dose, without sacrificing diagnostic
accuracy. The technique chart is provided for reference. The protocol development
process outlined in this work could be readily generalized to other imaging clinical
tasks.
Key Word
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Article info
Publication history
Published online: April 30, 2022
Accepted:
March 17,
2022
Received in revised form:
March 7,
2022
Received:
September 29,
2021
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
