Program Information

To Remove Or Not to Remove: Comfort Pads From Beneath Neonates for Radiography

X Jiang*, M Baad , I Reiser , K Feinstein , Z Lu , University of Chicago, Chicago, IL

Presentations

WE-E-18A-6 Wednesday 1:45PM - 3:45PM Room: 18A

Purpose: Comfort pads in neonatal incubators have been identified as a potential contributor to unnecessary patient exposure. A previous study reported significant (12%-72%) attenuation of x-ray beam by pads based on machine reported exposure index (EI), and a policy change was called for to remove pads for radiography (Rattan et al. 2013). In this study, we examine the validity of these results by direct measurement of exposure with dosimeters. Furthermore, the impact of the pads on image quality was assessed quantitatively.

Methods: Comfort pads from three commonly used incubators were examined in the range of 50-80 kVp with GE and Shimadzu digital radiography systems. Three experiments were conducted. First, the attenuation of the primary beam was measured using a narrow beam geometry. Second, the attenuation of both the primary and the scatter were measured with a broad beam geometry, using a 5-cm thick acrylic phantom to simulate a newborn. The results were also compared to the EI reported by the machine. Last, the reduction in image quality due to pads was assessed using a contrast-detail (C-D) phantom. Contrast to noise ratio (CNR) was calculated from multiple regions of interest as a measure of image quality.

Results: The attenuation of the primary beam ranged from 8% to 19%. The attenuation of both the primary and scatter was 15%-20% on the GE system and 6%-15% on the Shimadzu system. The attenuation calculated from EI deviated from the dosimeter results. The reduction in CNR due to pads was less than 20% in most cases. Visual inspection of the C-D phantom images did not reveal any apparent loss in object detectability.

Conclusion: Comfort pads on incubators were found to be moderately attenuating and only cause minor loss in image quality. Considering the fragile condition of neonates, removal of comfort pads is not justified.

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