title: Use of incentive spirometry in portable chest radiography.
abstract: OBJECTIVE
  The degree of lung inflation seen on a chest radiograph is dependent on the point during the patient's respiratory cycle at which the radiographer exposes the image receptor. Exposing the image receptor at the exact peak of inflation can be difficult because of the limited time available in which to capture the inspiratory pause. An incentive spirometer can indicate the moment of peak inhalation. This study tested whether images taken with and without an incentive spirometer display different levels of image quality.
  
  
  METHODS
  This is a paired, prospective, single-blinded study of 30 patients undergoing portable chest radiography. The radiographs were acquired with and without the use of an incentive spirometer. Visual grading analysis was performed using the 1996 European Guidelines on Quality Criteria for Diagnostic Radiographic Images.
  
  
  RESULTS
  The mean patient age was 53 years. Sixty images were acquired, 30 with the use of incentive spirometry and 30 without. The most common indication for portable chest radiography was "postlung lobectomy."
  
  
  CONCLUSIONS
  Scoring on the radiologist's ability to see the sixth rib, spine, trachea, and cardiac border was not affected significantly by the use of incentive spirometry. Use of an incentive spirometer was associated with significant improvement in ability to see the 10th rib (P ≤ .004), vascular pattern (P ≤ .001), retrocardiac lung (P ≤ .013), and the costophrenic angles (P ≤ .005).
  
  
  CONCLUSIONS
  This study introduces a technique to improve the quality of portable chest radiographs. The use of incentive spirometry improved inspiratory depth and image quality for portable chest radiographs.
authors.forename: Mark F
authors.initials: MF
authors.lastname: McEntee
authors.forename: Nariman
authors.initials: N
authors.lastname: Houssein
authors.forename: Dhafir
authors.initials: D
authors.lastname: Al-azawi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D019095:Point-of-Care Systems; D011856:Radiographic Image Enhancement / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D016037:Single-Blind Method; D013147:Spirometry / Q000379:methods*; D055815:Young Adult