June 22, 2017

Part 1: Lacking Grid Usage in Mobile Radiography – Convenience, or Negligence?

Recently, some radiographers have expressed that they would prefer not to use a grid for all mobile radiographic exams. The top three reasons commonly cited for this are:

  1. The grid’s weight,
  2. difficulties with positioning, and
  3. patient discomfort.

At first glance, these seem like legitimate reasons to do away with grids on portables. But, are radiographers considering the potential ramifications of removing a component piece that improves diagnostic quality in imaging?

Grids are an integral part of the imaging chain. They have been successfully used for decades to diagnose patients by improving detail and contrast.

It is important that the healthcare industry completely vet any new procedures that are introduced which have already been performed successfully in the past. Otherwise, why should the procedure change at all?

Challenges in Mobile Radiography

A lack of grid usage in mobile radiography seems to be happening more often, and that’s what we want to address in this article series.

There are several types of new grid emulation software applications available which make a number of claims regarding image quality. Hospitals across the globe are embracing this new technology at a rapid pace.

To be successful, mobile radiography requires the right balance of the main technical considerations associated with it. The use of grids is one of these main considerations.

On that note, let’s get some historical facts straight about grids.

3 Key Facts About Grids

  • Over the past 50-60 years, grids have decreased in weight. For example, a 14 x 17 in. 215 lpi grid (a newer technology) is 2 to 3 lbs. lighter compared to a 14 x 17 in. 103 lpi grid. That is a minor shift, but a shift nonetheless. Ask any tech – every pound counts with portables.
  • Grid use on portable CXRs was never commonplace – except for with KUBs or thicker anatomy. The general rule of thumb for grid use is if the anatomy of interest is 10cm or thicker, or if we use a technique of 70kVp or higher.
  • Imaging receptors have seen a dramatic increase in weight – their weights have nearly doubled over time. This additional weight from grids that X-ray techs seem to be reporting is more likely coming from the imaging receptors themselves – not the grids.

Has the advent of new technology that allows a hospital department to improve its workflow also burdened the very same healthcare providers that work for that department – the radiographers that must use them daily?

And is that burden really worth the results?

Verdict Still Out on Grid Usage

Grid usage in mobile radiography is undefined – the verdict is still out on it. More data needs to be had, but are hospitals jumping on the technology without considering the possible fallout that could occur?

Radiographic images are subjective – they are seen by the eye. Television is subjective as well, but these two mediums are vastly different in the way the image is generated. Ionizing radiation is harmful to people, while TV sharpness and detail is for viewing pleasure.

When it comes to potentially saving or damaging lives, are we treating the subject of grid usage with enough care?

Stay tuned for Part 2 of this series where we delve deeper into this conversation.