July 20, 2017

Part 3: Lacking Grid Usage in Mobile Radiography – Software vs. Hardware & What Works Best

There seems to be a trend taking shape in mobile radiography. Grid usage itself has decreased, and new grid emulation software applications are being embraced quickly by hospitals around the world.

Recently we shared with you some background on imaging receptors, a reason being used to promote grid emulation software over hardware, and now we’re going to dig into the issue at hand: let’s explore the next reason being touted to promote anti-scatter grid emulation software over grid hardware, and whether that reason is legitimate.

Another Reason to Use Software – It Eliminates Grid Cutoff from Poor Positioning

One of the most common complaints heard today about grids from radiographers is that they are too difficult to position without getting grid cutoff. Grid cutoff occurs when the tube head is not perpendicular to the grid and imaging receptor. Misalignment will cause grid cutoff and potentially a repeat exam. That is true. However, radiologic technologists are trained to use grids and achieve perpendicularity and proper alignment. They practice this daily and should be able to properly demonstrate this before passing their registry.

It is illogical from a medical, technical and ethical standpoint to avoid using a device that was invented for the sole purpose of increasing detail and contrast – yielding a more diagnostic superior image in hopes of visualizing potentially unseen pathology, because the radiographer is unable to perform their job properly.

When grids are used, there is no deconstructing and reconstruction of the image to reduce image degradation caused by scatter. With grids, the X-ray photons that are not meant for the image are absorbed by the lead in the grid, and they do not reach the imaging receptor (or anything else in the room, for that matter). It’s that simple. Grids absorb scatter radiation while grid emulation software does not. The scatter radiation reaches both the patient and anyone else in the vicinity, including the x-ray tech.

With the majority of radiologic exams performed, the grid needs to be perpendicular to the anatomy of interest. Again, perpendicularity is something a radiologic technologist accomplishes on a daily basis. In mobile radiography, it does take a little more time, effort and skill to make this happen – to position the grid properly – and may cause some patient discomfort, however it also may save lives.

When the correct grids are selected, properly matched and positioned, a grid will out-perform the emulation software when it comes to scatter reduction and image quality. If this was not the case it would defy the laws of quantum mechanics. Don’t believe me? Ask a radiophysicist.

Where Do Radiographic Protocols Come From Today?

In our current healthcare field, it seems that there may be no one left policing what one facility to the next is allowed to do when it comes to imaging protocols. To add to that, it seems like no one is keeping an eye on some equipment manufacturers’ potentially deceptive marketing. Remember, cigarette companies at one point in time touted the health benefits of smoking.

Does this new grid emulation software impact a radiologist’s ability to spot potentially life-threatening pathology? Could it cause more scatter radiation to reach the radiologic technologist if improper techniques are used, increasing occupational hazard? Where are the occupational hazard safety studies? There are a lot of unanswered questions, and here is another question.

Is it possible that a patient could go undiagnosed with the use of grid software just so the radiographer can save time by not paying attention to positioning in order to see more patients?

Stay tuned for Part 4 of this series where we continue this conversation by looking into the No. 1 reason touted to promote anti-scatter grid emulation software over grid hardware – dose reduction in diagnostic radiography.