Effect of comfort pads and incubator design on neonatal radiography.
BACKGROUND
There has been increasing interest in patient dose reduction in neonatal intensive care units. Removing comfort pads for radiography has been identified as a potential means to decrease patient dose.


OBJECTIVE
To assess the effect of comfort pads and support trays on detector entrance exposure (DEE) and image quality for neonatal radiography, and its implication for patient dose.


METHODS
Comfort pads and support trays from three incubator and warmer systems were examined. The attenuation of the primary beam by these structures was measured using a narrow beam geometry. Their effect on DEE and image quality was then assessed using typical neonatal chest radiography techniques with three configurations: 1) both the comfort pad and support included in the beam, 2) only the support tray included and 3) both the comfort pad and support tray removed.


RESULTS
Comfort pads and support trays were found to attenuate the primary beam by 6-15%. Eliminating these structures from the X-ray beam's path was found to increase the detector entrance exposure by 28-36% and increase contrast-to-noise ratio by more than 21%, suggesting room for patient dose reduction when the same image quality is maintained.


CONCLUSIONS
Comfort pads and tray support devices can have a considerable effect on DEE and image quality, with large variations among different incubator designs. Positioning the image detector directly underneath neonatal patients for radiography is a potential means for patient dose reduction. However, such benefit should be weighed against the risks of moving the patient.
Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637, USA. jiangxia@uchicago.edu.
Xia
X
Jiang
Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637, USA.
Michael
M
Baad
Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637, USA.
Ingrid
I
Reiser
Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637, USA.
Kate A
KA
Feinstein
Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637, USA.
Zhengfeng
Z
Lu
D001512:Bedding and Linens; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007186:Incubators, Infant; D007231:Infant, Newborn; D008297:Male; D056888:Patient Positioning / Q000295:instrumentation; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis* / Q000517:prevention & control*; D011835:Radiation Protection / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods
Contrast-to-noise ratio; Detector entrance exposure; Incubator; Neonate; Radiography