Digital radiograph rejection analysis during "Coronavirus disease 2019 (COVID-19) pandemic" in a tertiary care public sector hospital in Khyber Pakhtunkhwa Province of Pakistan.

Background: Evaluation of X-ray reject analysis is an important quality parameter in diagnostic facility. The aim of this study was to find out the radiograph rejection and its causes during the coronavirus disease 2019 (COVID-19) pandemics as there was fear of coronavirus disease infection among the technical staff from the incoming patients in a busy, high volume public sector tertiary care hospital.

Materials and method: This descriptive study was conducted at Radiology Department, Lady Reading Hospital, Peshawar from August to November, 2020. The rejected radiographs and their causes were analyzed.

Results: A total of 15,000 X-ray procedures were conducted during study period out of which 2550 cases were repeated making the total rejection 17%. Rejection in male and female were 74.3 and 25.7%, respectively, while rejection in adults was (80.1%) and (19.9%) in pediatric age group of the total rejection. The main cause of rejection was positioning (30.5%) followed by artifacts (22.4%), motion (12.1%), improper collimation (10%), wrong labeling (8.4%), exposure errors (6.9%), detector errors (3.7%), machine faults (2.8%), re-request from referring physician (1.7%), and PACS issues (1.5%). In terms of body anatomical parts, the highest rejection was observed in extremities (44.1%), followed by chest radiography (23.3%), spine (11.4%), abdomen (6.4%), skull (5.9%), pelvis (4.7%), KUB (3.7%), and neck (0.6%), respectively.

Conclusion: Radiograph rejection is common problem in every diagnostic facility but significant reduction can be achieved by implementing rejection analysis as basic quality indicator, and conducting technologist/s specific training programs for their knowledge and skill enhancement.