15 Best Practices in Digital Radiography (DR)

The American College of Radiology (ARC) practice guideline for Digital Radiography (DR) is meant “to provide guidance and assistance in the understanding and clinical use of digital radiography equipment in order to deliver optimal image quality at appropriate radiation doses, and to ultimately provide excellent safety and care for patients undergoing digital radiography examinations.” In line with the ARC practice guideline, a team of professionals from The American Society of Radiologic Technologists (ASRT), a leading professional association for medical imaging and radiation therapy, produced the whitepaper, “Best Practices in Digital Radiography.”

The purpose of this article is to present a more condensed collection of numerous best practices in DR as discussed in the ASRT’s whitepaper, “Best Practices in Digital Radiography.”

  1. Based on a planned exposure system designed in collaboration with radiologists, select the appropriate exposure technique factors the patient’s size and condition to determine adequate image quality for diagnosis.
  2. The screening of patients for potential pregnancy is essential.
  3. Consistent inclusion of information regarding the image receptor exposure in the image data provided throughout the image archiving process.
  4. Carefully review the examination ordered to prevent potential duplication and to ensure appropriateness as related to the patient’s history.
  5. Use the highest kVp within the optimal range for the position and part coupled with the lowest amount of mAs needed to provide an adequate exposure to the image receptor.
  6. Use Automatic Exposure Control (AEC) when indicated. Use AEC that has been calibrated to the type of image receptor to provide a consistent exposure to the image receptor.
  7. Use exposure technique charts that are continuously approved for the procedure.
  8. Use lead shielding for anatomic parts that are adjacent to the x-ray field.
  9. Consistent use of lead anatomic side markers captured on the original image during the x-ray exposure.
  10. For bod parts that exceed 10 cm, use a grid with specifications recommended by the digital imaging equipment vendor.
  11. Become familiar with Exposure Indicator (EI) standards for equipment, and newer standardized EI and Deviation Index (DI) as they become available new and upgraded equipment use.
  12. Use immobilization devices when needed and prevent repeat exposures by appropriately positioning the patient.
  13. Recognize image artifacts and prevent future artifacts from occurring by properly maintaining or acquiring service for the digital radiography equipment. Select the correct processing menu for an examination to ensure image quality.
  14. Electronically record exposure technique, EI, and dose data with the radiographic image to allow for assessment and refinement of technique selection practices.
  15. Implement a comprehensive quality assurance program that involves aspects of quality control and continuous quality improvement.

The 26-page document, “Best Practices in Digital Radiography,” can be found in its entirety here >>

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