Çocuk kliniklerinde çekilen direk radyografilerin kalitatif değerlendirilmesi

Purpose: No method exists today that reverses the risks of exposure to radiation. Because of this, it is important to abide by the principle of A(s) L(ow) A(s) R(easonably) A(chievable) when dealing with X-rays in diagnosis and treatment. We made a qualitative evaluation of direct radiography taken for diagnostic purposes in our pediatric clinic. Materials and Methodology: The direct radiographs taken for diagnostic purposes from patients presenting at our university hospital’s pediatric clinics (polyclinic-service floor-intensive care) over the period from the beginning of January 2015 to the end of March 2015 were retrospectively assessed in the study. A list of patients was obtained from the computer records. Thirteen different physicians had ordered the radiography. The radiological images matching the patient list were filed via PACS (Picture Archiving and Communication System) in the DICOM (Digital Imaging and Communication in Medicine) format. The images obtained were processed and classified with the open-source software OsiriX. The database was subsequently formatted. Dividing the database into two sections, two separate radiologists evaluated it according to the BASICS (Beam, Artifact, Shielding, Immobilization, Collimation, Structures) principles. The results were statistically interpreted in the electronic medium. Results: The study made use of 711 direct radiographs obtained from a total of 552 patients. The patients’ ages ranged from 1 day to 18 years. More than one imaging had been made for 158 of the patients. A large majority of the radiography had been taken for the purpose of lung imaging. In addition to these, the radiography also included among others, standing direct abdominal radiographs, Waters views, and wrist radiographs. Seventy-four percent (n=528) of 711 of the imaging had kVp values. The metadata for the radiography did not include data for the other components of the beam or dose, namely Part Thickness (cm), mA, Time, mAs, SID, IR size, Exposure Indicator (EI). Artifacts were observed in five percent (n=36) of the cases. Shielding had been performed in only 4 (<1%) of the cases. The immobilization rate was optimal in 98% (n=698) of the cases. Collimation was optimal in 48% (n=342) of the cases. The other cases were deficient. Digital cropping had been performed in only 32 of the imaging (4.5%). In 90% (n=639) of the cases, all possible structures were complete in the radiography; in other words, the organs that had been aimed at were present. Conclusions: We tracked the imaging scenarios of cases in which beam (dosing) metadata were not available. Metadata values were entered prior to all imaging. It was seen however that the values had not been recorded in the database because of the manufacturers’ unawareness of the importance of the matter. As can be seen in the study’s results, all of the components of the BASICS principles outside of immobilization are open to improvement. Awareness must be raised, particularly in pediatricians, as well as radiology technicians, radiologists and administrators. The matter can be resolved with a program of measuring, evaluating, planning and implementation. The result of our study was that BASICS training began at our institution.