Manipulation of projection approach in pediatric radiography.

Purpose: To determine whether manipulating routine projections from anteroposterior (AP) to posteroanterior (PA) during projection radiography studies will result in reduced pediatric radiation exposure.

Method: A literature analysis was conducted on pediatric radiation exposure, radiation protection, and tissue weighting factors. Multiple quantitative datasets were used to support findings related to projection manipulation.

Results: Dosimetric studies confirm that the PA projection significantly decreases radiation exposure to nearly all radiosensitive tissue, with the exception of the patient's bone marrow.

Discussion: Pediatric patients are inherently more sensitive to ionizing radiation, making this patient population a major focus of dose-reduction issues. Radiologic technologists are charged with keeping dose as low as reasonably achievable (following the ALARA principle), and performing PA projections rather than routine AP projections might decrease radiation to the pediatric population.

Conclusion: The PA projection results in a definitive reduction in radiation exposure to the majority of radiosensitive organs and tissues and should be considered for implementation on a routine basis.