A national review of X-ray imaging protocols in Irish hospital radiology departments

IF 2.8 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2025-08-23 DOI:10.1016/j.radi.2025.103128

M. O'Connor, S. Lynch, J. Walsh

{"title":"A national review of X-ray imaging protocols in Irish hospital radiology departments","authors":"M. O'Connor, S. Lynch, J. Walsh","doi":"10.1016/j.radi.2025.103128","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Projection radiography remains the most commonly used imaging modality in Irish hospitals. This study reviewed X-ray imaging protocols nationwide, assessing their structure, consistency, and alignment with clinical guidelines by comparing documentation, listed projections, and associated clinical indications.</div></div><div><h3>Method</h3><div>A descriptive comparative design was used to evaluate X-ray imaging protocols from 23 Model 3 and Model 4 Irish hospitals. With permission from respective Radiology Services Managers, X-ray protocols were analysed for format, anatomical coverage, projection listings, and clinical indications. Data were coded using binary and categorical systems. Descriptive statistics, one-way ANOVA, Chi-square, and multiple regression analyses were applied to assess patterns and associations.</div></div><div><h3>Results</h3><div>Protocols varied significantly in format, content, and number of projections (range: 65–110; mean = 91). Only 30 % used the national Health Service Executive template, and 35 % lacked comprehensive clinical indications. A total of 178 distinct projections were identified. No significant association was found between hospital type, size, or orthopaedic services and protocol comprehensiveness. Discrepancies emerged in the use of lateral chest, bone age, temporomandibular joint, and sinus imaging, with some protocols diverging from iRefer recommendations. Significant inconsistency was also observed in trauma shoulder and weight-bearing lower limb protocols.</div></div><div><h3>Conclusion</h3><div>This study offers the first comprehensive analysis of X-ray imaging protocols in Ireland, revealing significant variations. While generally aligning with iRefer guidelines, these protocols show a clear lack of national standardisation in structural elements, clinical indications, and specific projection choices for less common examinations.</div></div><div><h3>Implications for practice</h3><div>These findings offer valuable insights for standardising X-ray protocols across Ireland.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"31 6","pages":"Article 103128"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiography","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S107881742500272X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Projection radiography remains the most commonly used imaging modality in Irish hospitals. This study reviewed X-ray imaging protocols nationwide, assessing their structure, consistency, and alignment with clinical guidelines by comparing documentation, listed projections, and associated clinical indications.

Method

A descriptive comparative design was used to evaluate X-ray imaging protocols from 23 Model 3 and Model 4 Irish hospitals. With permission from respective Radiology Services Managers, X-ray protocols were analysed for format, anatomical coverage, projection listings, and clinical indications. Data were coded using binary and categorical systems. Descriptive statistics, one-way ANOVA, Chi-square, and multiple regression analyses were applied to assess patterns and associations.

Results

Protocols varied significantly in format, content, and number of projections (range: 65–110; mean = 91). Only 30 % used the national Health Service Executive template, and 35 % lacked comprehensive clinical indications. A total of 178 distinct projections were identified. No significant association was found between hospital type, size, or orthopaedic services and protocol comprehensiveness. Discrepancies emerged in the use of lateral chest, bone age, temporomandibular joint, and sinus imaging, with some protocols diverging from iRefer recommendations. Significant inconsistency was also observed in trauma shoulder and weight-bearing lower limb protocols.

Conclusion

This study offers the first comprehensive analysis of X-ray imaging protocols in Ireland, revealing significant variations. While generally aligning with iRefer guidelines, these protocols show a clear lack of national standardisation in structural elements, clinical indications, and specific projection choices for less common examinations.

Implications for practice

These findings offer valuable insights for standardising X-ray protocols across Ireland.

查看原文本刊更多论文

爱尔兰医院放射科x射线成像协议的全国审查

在爱尔兰医院中，放射投影成像仍然是最常用的成像方式。本研究回顾了全国范围内的x射线成像方案，通过比较文献、列出的投影和相关临床适应症来评估其结构、一致性和与临床指南的一致性。方法采用描述性比较设计对23家爱尔兰模型3和模型4医院的x射线成像方案进行评价。在各自放射学服务经理的许可下，对x射线协议的格式、解剖覆盖范围、投影清单和临床适应症进行了分析。数据采用二进制和分类系统编码。描述性统计、单因素方差分析、卡方分析和多元回归分析用于评估模式和关联。结果各方案在投影的格式、内容和数量上有显著差异（范围：65-110，平均值= 91）。只有30%的人使用国家卫生服务执行模板，35%的人缺乏全面的临床适应症。总共确定了178个不同的投影。医院类型、规模或骨科服务与协议的全面性之间没有发现显著的关联。在侧胸、骨龄、颞下颌关节和鼻窦成像的使用中出现了差异，一些方案与ireference的建议不同。在创伤肩关节和负重下肢治疗方案中也观察到显著的不一致。结论：本研究首次对爱尔兰的x射线成像方案进行了全面分析，揭示了显著的差异。虽然总体上与ireference指南一致，但这些方案在结构要素、临床适应症和不常见检查的具体投射选择方面明显缺乏国家标准化。实践意义这些发现为整个爱尔兰的x射线标准提供了有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.