Towards faster quality control of personal radiation protective equipment using CT scout or a dedicated biplanar radiography device.

Quality control (QC) of personal radiation protective equipment (PRPE) is essential to detect tears and holes in the attenuating layers. Routinely, this QC is performed using fluoroscopy on a conventional X-ray table. However, such a QC procedure is laborious and time consuming. This study aims to establish faster PRPE QC using CT scout or a biplanar radiography device. A reproducible 0.25 mm lead-equivalent phantom of ten holes (diameter 10 mm - 1 mm) and two incisions (length 50 mm and 25 mm with a width of 0.63 mm) was created to assess the defect detection performance using fluoroscopy, CT scout (Siemens Somatom Definition Flash and GE Revolution) and a biplanar radiography device (EOS). Additionally, three pieces of PRPE were imaged on all modalities and compared in terms of speed and defect detection performance. Defect quantification was performed with an X-ray opaque grid, the modality's line tool and the built-in wand tool in ImageJ software. All modalities could visualize the smallest defects (1 mm). However, for the Siemens Flash, the smallest defect was only visible when the scout length was at most 50 cm. Fluoroscopy was the most time consuming (>1 min/piece). Both CT scout and the EOS allowed faster analysis (<10 s). The EOS system had the highest resolution of 5.19 pixels/mm for all set scan speeds. However, to image the reference pieces, a seamstress doll was needed. The wand tool was found to be the most accurate for defect estimation. Both the EOS and a CT scout allowed faster QC of PRPE with equivalent defect detection performance. However, specific positioning and scan length must be considered.