Comparative analysis of lateral cervical radiographic imaging quality with and without anti-scatter grid application

IF 2.1 3区工程技术 Q3 CHEMISTRY, INORGANIC & NUCLEAR

Applied Radiation and Isotopes Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI:10.1016/j.apradiso.2026.112459

Daša Lučić , Laura Jurša , Erna Alukić , Nejc Mekiš

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Abstract

Purpose

This study investigated the effects of anti-scatter grid removal on radiation dose, image quality, and anatomical visibility in lateral (LAT) cervical spine imaging.

Methods

A two-part prospective study was conducted. In the phantom study, an anthropomorphic head-torso phantom with lard simulating extra fatty tissue of 2–10 cm in 2 cm increments was imaged using protocols with and without an anti-scatter grid. In the clinical study, 80 patients were randomly divided into two groups: half were imaged with an anti-scatter grid, and half without. Data collected included gender, body mass index (BMI), Dose Area Product (DAP), tube voltage (kV), current-time product (mAs), filtration, neck width, and use of Automatic Exposure Control (AEC). Effective dose (ED) and dose to selected organs were calculated using PCXMC 2.0 software. Two traumatologists and one radiologist evaluated all phantom and patient images according to European guidelines using a four-point scale (1 = diagnostically inadequate image; 4 = excellent image quality).

Results

In the phantom study, removal of the anti-scatter grid reduced mean DAP by 52.1 % (p < 0.001) without affecting diagnostic adequacy; soft tissue-bone contrast improved (p = 0.009). In the patient study, removal of the anti-scatter grid reduced mean DAP and ED by 63.1 % and 61.7 %, respectively (both p < 0.001). All organ doses were significantly lower (p < 0.001). Soft tissue visibility improved by 12.5 % (p = 0.011), and soft tissue-bone contrast improved by 9.1 % (p = 0.007) without the anti-scatter grid. No other quality criteria differed significantly.

Conclusion

In both phantom and patient studies, removal of the anti-scatter grid resulted in significant dose reduction while maintaining or improving image quality. These results are consistent with previous findings and support the As Low As Reasonably Achievable (ALARA) principle. Omitting the anti-scatter grid in LAT cervical spine imaging reduces dose by about 60 % without compromising diagnostic quality. Routine use in clinical practice is recommended to increase patient safety.

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有无反散射网格应用的颈椎侧位片成像质量比较分析

目的研究反散射网格去除对颈椎侧位成像中辐射剂量、图像质量和解剖可见性的影响。方法采用两部分前瞻性研究。在幻体研究中，一个拟人化的头躯干幻体用猪油模拟2 - 10厘米的额外脂肪组织，以2厘米的增量进行成像，使用有和没有反散射网格的方案。在临床研究中，80例患者被随机分为两组：一半有反散射网格成像，一半没有。收集的数据包括性别、体重指数（BMI）、剂量面积积（DAP）、管电压（kV）、电流时间积（mAs）、过滤、颈宽和自动暴露控制（AEC）的使用情况。采用pcxmc2.0软件计算有效剂量（ED）和对选定器官的剂量。两名创伤学家和一名放射科医生根据欧洲指南使用四分制评估所有幻影和患者图像（1 =诊断不充分的图像；4 =良好的图像质量）。结果在假体研究中，去除反散射网格使平均DAP降低52.1% (p < 0.001)，但不影响诊断的充分性；软组织-骨对比改善（p = 0.009）。在患者研究中，去除反散射网格使平均DAP和ED分别降低了63.1%和61.7% （p < 0.001）。所有器官剂量均显著降低（p < 0.001）。未加防散射网格后，软组织可见性提高12.5% (p = 0.011)，软组织-骨对比提高9.1% （p = 0.007）。其他质量标准无显著差异。结论在幻影和患者研究中，去除反散射网格可以显著降低剂量，同时保持或改善图像质量。这些结果与先前的研究结果一致，并支持尽可能低的合理可达（ALARA）原则。在LAT颈椎成像中，在不影响诊断质量的情况下，省略反散射网格可减少约60%的剂量。建议在临床实践中常规使用，以提高患者的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Radiation and Isotopes 工程技术-核科学技术

CiteScore

3.00

自引率

12.50%

发文量

406

审稿时长

13.5 months

期刊介绍： Applied Radiation and Isotopes provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and peaceful application of nuclear, radiation and radionuclide techniques in chemistry, physics, biochemistry, biology, medicine, security, engineering and in the earth, planetary and environmental sciences, all including dosimetry. Nuclear techniques are defined in the broadest sense and both experimental and theoretical papers are welcome. They include the development and use of α- and β-particles, X-rays and γ-rays, neutrons and other nuclear particles and radiations from all sources, including radionuclides, synchrotron sources, cyclotrons and reactors and from the natural environment. The journal aims to publish papers with significance to an international audience, containing substantial novelty and scientific impact. The Editors reserve the rights to reject, with or without external review, papers that do not meet these criteria. Papers dealing with radiation processing, i.e., where radiation is used to bring about a biological, chemical or physical change in a material, should be directed to our sister journal Radiation Physics and Chemistry.