A pilot study evaluating erect chest imaging in children, using the Lodox Statscan digital X-ray machine

Abstract

ABSTRACT Background: Chest radiography accounts for a significant proportion of ionising radiation in children. The radiation dose of radiographs performed on the Lodox Statscan system has been shown to be lower than that of a computed radiography (CR) system. The role of the Lodox Statscan (hereafter referred to as the Statscan) in routine erect chest radiography in children has not been evaluated. Objective: To evaluate the image quality and diagnostic accuracy of erect paediatric chest radiographs obtained with the Statscan and compare this with conventional erect chest images obtained with a CR system. Materials and Methods: Thirty three children with suspected chest pathology were enrolled randomly over a period of three months. Erect chest radiographs were obtained with the Statscan, and a Shimadzu R-20J X-ray machine coupled with a Fuji FCR 5000 CR system. Image quality and diagnostic accuracy and diagnostic capability were evaluated between the two modalities. Results: The erect Statscan allowed superior visualisation of the three major airways. Statscan images however, demonstrated exposure and movement artifacts with hemidiaphragms and ribs most prone to movement. Bronchovascular clarity was also considered unsatisfactory on the Statscan images. Conclusion: The Statscan has limitations in erect chest radiography in terms of movement artefacts, exposure fluctuations, and poor definition of lung markings. Despite this, the Statscan allows better visualisation of the major airways, equivalent to a ‘high KV’ film at a fraction of the radiation dose. This supports the finding of an earlier study evaluating Statscan images in trauma cases, where the images were taken supine. Statscan has great potential in assisting in the diagnosis of childhood tuberculosis where airway narrowing occurs as a result of nodal compression.