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Nationwide Evaluation of X-ray Trends Survey of Abdomen and Lumbosacral Spine Radiography¹

¹ From the Center for Devices and Radiological Health, Division of Mammography Quality and Radiation Programs, U.S. Food and Drug Administration, 1350 Piccard Dr, HFZ-240, Rockville, MD 20850. Received April 3, 2002; revision requested June 12; final revision received January 22, 2004; accepted March 3. Address correspondence to D.C.S. (e-mail: david.spelic@fda.hhs.gov).

Results of the 1995 Nationwide Evaluation of X-ray Trends (NEXT) survey of facilities that perform diagnostic radiographic examinations of the abdomen and lumbosacral spine were compared with those of previous NEXT surveys conducted in 1987 and 1989. A clinically validated radiographic phantom was used in the 1995 survey to capture data about radiation exposure and image quality. Additional data were obtained regarding clinical techniques, facility workloads, x-ray beam quality, film processing quality, and darkroom fog. Mean skin-entrance air kerma for the abdomen examination dropped from 3.2 mGy (in 1987) to 2.8 mGy at hospitals and from 3.4 mGy (in 1989) to 3.0 mGy at nonhospital facilities. Mean skin-entrance air kerma also decreased for the lumbosacral spine examination from 3.7 mGy (in 1987) to 3.3 mGy at hospitals and from 3.8 mGy (in 1989) to 3.2 mGy at nonhospital facilities. The quality of film processing improved, although 58 (18.3%) of 317 surveyed facilities did not meet the Mammography Quality Standards Act standard for film processing quality, compared with 185 (5.9%) of 3,120 mammography facilities inspected in 1995. Finally, 181 (58.0%) of 312 surveyed facilities had darkroom fog levels greater than the Mammography Quality Standards Act standard, compared with 1,426 (16.6%) of 8,605 mammography facilities inspected in 1995.

Index terms: Abdomen, radiography, 70.11 • Dosimetry • Radiations, exposure to patients and personnel • Radiations, measurement • Screens and films • Special Reports • Spine, radiography, 33.11

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