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Reject film Analysis
The document discusses reject film analysis in radiology. Reject film analysis measures actual quality against standards and identifies necessary corrective actions. It aims to minimize patient exposure, reduce costs, improve throughput and image quality. Common reasons for rejected films include positioning errors, under/over exposure, and patient movement. Analyzing reject films helps address equipment issues and identifies areas for improved training.
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Reject film Analysis
- 1. REJECT FILM ANALYSIS SUNIL KUMAR SEKSANA, Lecturer sunilkrseksana@gmail.com
- 2. In Radiology manygroups of professionals are involved who share their responsibility which are clearly defined. Each group has an important part in the output of the entire process, and their overall roles, as well as their specific quality assurance roles, are interdependent, requiring close cooperation specially in large healthcare delivering system where Each staff member must have qualifications (education, training and experience) appropriate to his or her role and responsibility.
- 3. Film Analysis????????? Film/Imageanalysis’ is the regulatory process through which the actual quality performance is measured, compared with existing standards, and the actions necessary to keep or regain conformance with the standards.
- 4. Reject Film Analysis???????? Reject Film analysis is all those planned and systematic actions necessary to provide adequate confidence that a product or service will satisfy the given requirements for quality of Image or Radiograph. It is a well-established indicator of quality control in radiology department.
- 5. World Health Organization(WHO) has recommended a permissible reject rate of 5%. Conference of Radiographic Control Programme Directorate (CRCPD’S) committee on Quality Assurance (QA) recommend a higher reject rate of 10%.
- 6. X-rays, one ofthe important diagnostic modalities being used worldwide in the healthcare services despite being associated with some radiation exposure to the patients. So the analysis of results become important for the safe, fast and error free delivering of services to the patients.
- 7. The practice ofradiographic imaging has undergone several changes with evolution of Digital Technology but traditional conventional film-screen radiography systems provide good image quality, high spatial resolution, generally low costs and off course living style which is particularly an important factor in health care delivery services in developing countries like India.
- 8. A number offilms are discarded for one reason or another???????
- 9. OBJECTIVE OF REJECTFILM ANALYSIS Minimize Patient exposure. Cost Reduction. High throughput. Better image quality. Identify the main errors and put measures to reduce them. Support claims for more funding to replace, modify or repair faulty equipment. Rejected film may be informative for teaching purposes.
- 10. Minimize Patient exposure Medical x-ray exposures are the largest man-made source of ionizing radiation. Recent developments in medical imaging have led to rapid increases in a number of high dose x-ray examinations performed with significant consequences in individual patient doses and the collective dose of the population as a whole.
- 12. • The InternationalCommission on Radiological Protection (ICRP) recommends that such medical exposure should be kept as low as reasonably achievable (ALARA principle). • One way of achieving this is through a quality assurance program, which includes reject film analysis. • As it reduces the number of repeat x-ray.
- 13. COST REDUCTION Controlon repeat X-ray will reduce the cost of X-ray film, Chemicals, electricity and other cost.
- 14. High throughput Controlon repeat X-ray will reduce the waiting of patient.
- 15. Better image quality Reject film analysis helps to identify the reason of reject film and helps in to enhance the image quality of the patients.
- 16. Support claims formore funding to replace, modify or repair faulty equipment. In conventional radiography underexposure was the most frequent factor responsible for the retake X-rays as compared to the other factors. The differ image quality in conventional radiographs due to the process of developing the X-ray films is eliminated with the use of digital radiography.
- 19. In digital radiography,the most frequent factor responsible for re-take X-ray is - positioning error (30%). - underexposure (28%). - overexposure (26%). - patient movements(6%). - portable procedure (1%). - grid cut-off (0.5%). - others (8.5%).
- 20. In the nearfuture, digital radiography system is proposed to be more important in clinical practice because of • advancement in computer technology. • expansion of storage capacities in these devices. • Different postprocessing tools. • possibility for multimodality image display. • use of computer-aided diagnosis software. • tele-radiology
- 21. Rejected film maybe informative for teaching purposes. Eyes See what the mind knows
- 22. • Quality assurancein diagnostic radiology is of paramount importance to provide quality services leading to better diagnostic yield and thus accurate and timely treatment. Reject analysis study was done in conventional radiography to find out the incidence and the causative factors so that necessary steps be taken to avoid these factors resulting in less repetition of films thus reducing cost and unnecessary radiation to patients and personnel working in radiology department
- 24. Its Radiographer’s responsibilityto use proper Markers which ensure the viewer about 1. The side(Left or Right) of the patient has examined. 2. Identity of the patient. 3. Time interval (For contrast Study like BMFT, IVP) 4. Identifying the operators. Note:- The first two must be present on the radiograph when we are taking radiograph on conventional x-ray film or with the help of computed Radiography System.
- 25. These 8 typesof markers accurately decide the body positioning and direction. This marker projects the elapsed time after injection of contrast medium
- 26. Clip on reversibleL/R marker. Clips over edge of cassette. X-ray Film Markers L & R Mitchell Markers Tapes onto cassettes. Easy to identify erect or supine position
- 27. Task Allocation Matrix Task Responsibility Frequency Verify Patient ID and exam info Radiographer Each exam Verify Patient Positioning Radiographer Each view Verify Image Quality – release or repeat Lead Radiographer Each image Verify exam in PACS Lead Radiographer Each exam Reconcile patient data/image counts in PACS Medical Informatics Incidental Report substandard images Radiologist Incidental Erase cassette-based image receptors Radiographer Start-of-shift Test image receptor uniformity Radiographer Weekly Clean cassette-based image receptors Radiographer Monthly Compile and review reject analysis data Lead Radiographer Monthly Verify display calibrations Clinical Engineer Quarterly Review QC indicators QA Committee Quarterly Verify receptor calibrations Medical Physicist Semi-Annual Verify x-ray generator functions Medical Physicist Annual
- 28. Artifacts in DigitalRadiography 28 Image plate artifacts ( In CR ). Due to cracking Imaging Plate
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- 35. OVER EXPOSED X-RAY FILM
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- 37. Film stuck toeach other during processing
- 38. Plate Reading Artifact( in CR ) 38 LLiinnee ccaauusseedd ffrroomm ddiirrtt ccoolllleecctteedd iinn aa CCRR RReeaaddeerr. Damaged Laser beam head in CR reader. Appears as multiple linear white lines.
- 39. 39 3. Imageprocessing artifacts Missing lines or pixels ( indicating digitization problems ).
- 40. towel used tohelp in positioning a child. 40 44..oo pp ee rr aa tt o orr eerrrroorrss Digital detector is MORE sensitive Double exposure: Radiographs of both feet and pelvis (arrowheads) on a single film.
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- 51. H.T. (High Voltage)Cable
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- 54. BACK SCATTER orCASSETTE UPSIDE DOWN
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- 56. ARTEFAT DUE TOTALCUM POWDER
- 57. ARTEFACT DUE TODEODORANT
- 58. ARTEFACT DUE TOHAIR BUN
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- 69. DUE TO CHOLECLIP
- 70. DUE TO INTRAUTERINEDEVICE
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- 72. Corrective Action Thepercentage of repeats should guide the facility to focus their efforts to those areas needing the most attention. For example, films that are too light or too dark may be due to processing problems, equipment problems that require repair or calibration, or technique charts may need updating.