Evaluation of Reject Analysis of Chest Radiographs in Diagnostic Radiology

Introduction: Reject analysis is an important quality indicator and is required for reducing radiation exposure to the patient and increased cost-effectiveness. Aim: The study aims to analyze reject rates and causes in direct chest radiographs to assess the radiographic quality. Materials and Methods: A total of 150 chest radiographs (CXR) had been retrospectively analyzed at King Fahad Hospital from January to March 2016. Results: The rejection rate was 14.7%. Positioning errors and artifacts were the most significant factors for reject analysis in chest radiography. Positioning errors are the most common cause of rejection (16%), and artifacts are the second reason (11.33%). In consequence to positioning error, the scapular shadow was partially located at the lung field in 38% of the images. Conclusion: chest radiographs are the most common x-ray examination requested. Positioning errors are still challenging, which affect the quality of the image. An overall rejection rate of 14.7% indicates a need for continuous practice in the Radiology department to improve the performance.