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Multi-Institution Consensus for Acquisition of Portable Chest Radiographs Through Glass Barriers

S McKenney1, J Wait2, V Cooper3, A Johnson4*, J Wang1, A Leung1, J Clements2, (1) Stanford University, Stanford, CA, (2) Kaiser Permanente, Pasadena, CA, (3) Kaiser Permanente, Berkeley, CA, (4) Kaiser Permanente, Union City, CA

Presentations

TU-D1000-IePD-F6-4 (Tuesday, 7/12/2022) 10:00 AM - 10:30 AM [Eastern Time (GMT-4)]

Exhibit Hall | Forum 6

Purpose: To conserve personal protective equipment and reduce exposure to potentially infected COVID-19 patients, several Californian facilities independently implemented a method of acquiring portable chest radiographs through glass barriers.

Methods: This work quantifies the transmission of radiation through a glass barrier using 6 radiographic systems at 5 facilities. Patient dose was estimated with and without the glass barrier. Beam penetrability and resulting image exposure indices were measured and used to adjust the tube current-time product (mAs) for glass barriers. Because of beam hardening, the contrast-to-noise ratio (CNR) was measured. Finally, scatter surveys were performed to assess staff radiation exposure inside and outside the exam room.

Results: The barriers attenuated a mean of 61% of the x-rays. When the mAs was increased to match exposure indices, there was no degradation of the CNR. This was corroborated with image quality assessments by radiologists. The glass filtered low-energy x-rays and some facilities observed slight changes in patient effective doses. There was scattering from both the phantoms and the glass barriers within the room.

Conclusion: Glass barriers require an approximate 2.5-times increase in beam intensity, with all other technique factors held constant. Further refinements are necessary for increased source-to-image distance and beam quality in order to match exposure indices. This does not result in a significant increase in the radiation dose to the patient. The use of lead aprons, mobile shields, and increased distance from scattering sources should be employed where practicable in order to keep staff radiation doses as low as reasonably achievable.

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