Radiographic Reject Film Analysis in Radiology Department of a Teaching Hospital in Jos, Plateau State, Nigeria

Abstract

In X-ray examinations, it is common to find patients undergo repeated X-Ray examinations after the initial X-Rays films were rejected for undiagnosable image quality. This often contributes to the radiation burden of the patients and waste of resources or avoidable extra cost in most radiology departments. This study aimed at evaluating the rate at which radiographic films used for diagnoses are rejected; assess the reasons for rejection and to obtain information for further image quality at the Teaching Hospital. A prospective method was adopted using radiographic films of good and poor diagnostic quality for a period of two years (January 2015 to December 2016). A total number of 5761 radiographs were studied, out of which 5285 were of good diagnostic quality. The 476 rejected films were analyzed with respect to size, type of procedure and reasons for rejection. The analysis of the rejected films indicated that over-exposure; under-exposure, poor positioning as well as poor processing contributed 28.39%, 20.65%, 13.87% and 11.29% respectively to the rejection. The reject rate was found to be 7.76% in 2015 and 8.98% in 2016, which are above the World Health Organisation and within the Conference of Radiation Control Program Directors (CRCPD) recommended permissible rate of 5% and (5-10%) respectively. The reasons identified for the film rejection could be due to incorrect setting of exposure factors, lack of communication between the operator and the darkroom technician and quality control test on the processor could be responsible for producing over and under exposed radiographs. The findings imply that the patients may have been exposed to avoidable radiation doses. Regular training in radiographic techniques and standardization of protocols as well as quality assurance measures in the hospital could help reduce the reported reasons for rejection.