Reducing Pediatric Patients' Dose by Manipulating Radiographic Projections.

Purpose: To determine whether radiologic technologists are manipulating projections to lower patient dose in routine pediatric radiography examinations.

Methods: Using a descriptive survey approach, members from the American Society of Radiologic Technologists with a primary registration in radiography were randomly selected and invited to share their experiences using alternative projections during routine pediatric radiography examinations.

Results: For this study, 404 completed responses were analyzed. More than half of the participants (67.6%) strongly agreed or somewhat agreed that the use of alternative projections can reduce pediatric dose during routine radiography examinations, and more than half (61.3%) strongly agreed, agreed, or somewhat agreed that the use of alternative projections is beneficial for dose reduction. Incidentally, the most common response from participants regarding their use of alternative projections during routine pediatric radiography examinations was occasionally or sometimes. Nearly three-fourths of the participants strongly agreed that radiation protection guidelines are important to follow during routine pediatric radiography examinations. Although many radiologic technologists in this sample felt proficient using alternative projections during pediatric procedures, they also believed additional training in such methods would be beneficial.

Discussion: Most institutions have imaging protocols in place; however, the use of alternative methods of projection during routine pediatric radiography examinations might heighten current radiation protection guidelines, leading to protocol changes to reduce dose and improve the overall wellbeing of pediatric patients. Furthermore, recent recommendations in the field of medical imaging regarding patient shielding practices might deem positioning to be a more important method for dose reduction. Consultations from radiologists might be necessary to ensure that image quality is sufficient and diagnostic detail is not compromised. Additional training specific to using alternative projections during routine pediatric radiography examinations also might be warranted.

Conclusion: Current practices do not suggest alternative methods of projection are applied regularly during routine pediatric radiography examinations. Considerations should be made to allow technologists to manipulate projections when permitted.