University of Utah School of Medicine, Department of Radiology and Imaging Sciences, Salt Lake City, UT.
University of Utah Hospital, Salt Lake City, UT.
Curr Probl Diagn Radiol. 2022 Jan-Feb;51(1):38-45. doi: 10.1067/j.cpradiol.2020.12.003. Epub 2021 Jan 9.
The novel coronavirus (COVID-19) pandemic has presented many logistical challenges, including unprecedented shortages of personal protective equipment (PPE). A technique of obtaining portable chest radiographs (pCXR) through glass doors or windows to minimize technologist-patient contact and conserve PPE has gained popularity, but remains incompletely evaluated in the literature. Our goal was to quickly implement this technique and evaluate image quality and radiation dose.
An infographic and video were developed to educate nurses and technologists on the through-glass pCXR technique. Imaging parameters were optimized using a phantom and scatter radiation was measured. Three reviewers independently evaluated 100 conventionally obtained and 100 through-glass pCXRs from March 13, 2020 to April 30, 2020 on patients with suspected COVID-19, using criteria for positioning and sharpness/contrast on a 1 (confident criteria not met) to 5 (confident criteria met) scale. Imaging parameters, including deviation index (DI) were recorded for all radiographs.
The through-glass method was rapidly adopted and conserved one isolation gown per interaction. Although there was a statistically significant difference in the positioning (P value 0.018) and sharpness/contrast (P value 0.016), the difference in mean ratings was small: 4.82 vs 4.65 for positioning and 4.67 vs 4.50 (conventional vs modified) for sharpness/contrast. Scatter radiation was measured using a thorax phantom and found to be acceptable for the patient and nearby personnel. Standard deviation was higher for the DI for the through-glass technique (2.8) compared to the conventional technique (1.8), although the means were similar.
The through-glass technique was quickly implemented, producing diagnostic quality chest radiographs while conserving PPE and reducing risks to radiology staff. There was more variability with imaging technique and DI using the through-glass technique, likely due to technologist uncertainty regarding technical modifications. Further work to reduce this variation is necessary to optimize quality and dose.
新型冠状病毒（COVID-19）大流行带来了许多后勤挑战，包括个人防护设备（PPE）的空前短缺。通过玻璃门或窗户获取便携式胸部 X 线摄影（pCXR）的技术已得到普及，但在文献中仍未得到充分评估。我们的目标是快速实施该技术并评估图像质量和辐射剂量。
我们制作了一个信息图和视频，对护士和技师进行了通过玻璃 pCXR 技术的培训。使用体模优化了成像参数，并测量了散射辐射。 2020 年 3 月 13 日至 4 月 30 日，三名审阅者独立评估了 100 例疑似 COVID-19 患者的 100 例常规和 100 例通过玻璃 pCXR 图像，使用定位和清晰度/对比度标准（1 表示未满足置信度标准，5 表示满足置信度标准）进行评估。记录了所有 X 射线的成像参数，包括偏差指数（DI）。
通过玻璃的方法得到了快速采用，每次交互可节省一件隔离服。尽管在定位（P 值 0.018）和清晰度/对比度（P 值 0.016）方面存在统计学差异，但平均评分差异很小：定位为 4.82 与 4.65，清晰度/对比度为 4.67 与 4.50（常规与改良）。使用胸部体模测量了散射辐射，发现对患者和附近人员是可接受的。与常规技术（1.8）相比，通过玻璃技术的 DI 标准差更高（2.8），尽管平均值相似。
通过玻璃的技术得到了快速实施，在节省 PPE 的同时产生了具有诊断质量的胸部 X 射线，并降低了放射科工作人员的风险。与常规技术相比，通过玻璃技术的成像技术和 DI 具有更大的变异性，这可能是由于技师对技术修改的不确定性所致。需要进一步的工作来减少这种变化，以优化质量和剂量。
