Determination and Analysis of Film Reject Rate at Eight Selected Governmental Diagnostic X-Ray Facilities in Tigray Region, Northern Ethiopian

BACKGROUND: In radiography examination, it is common to encounter patients undergoing repeated X-ray exposure after the rejection of a film image due to poor image quality. This subjects the patients to unnecessary radiation exposure and extra cost for the facility. This fact has required to investigate the causes of film rejection in common X-ray examinations. AIMS: This study aims to obtain images, which are adequate for the clinical diagnostic purpose with minimum radiation dose to the patient in X-ray radiographic examination using film rejects analysis. METHODS: A prospective, crosssectional study design was carried out for 3 months. The film rejection rate data were collected using standardized checklist as recommended by the National Radiation Protection Authority and International Atomic Energy Agency. Daily recordings were compiled by frontline radiographers and senior physicians. STATISTICAL ANALYSIS USED: Data were analyzed descriptively using SPSS of version 23 software. RESULTS: Overall rejection rate was 319 (10.02%) in 3183 X-ray exposures. The rejection rates by hospitals are 33.7% in Adwa, 13% in Aksum, 9.6% in Suhul, 9.2% in AbiAdi, 7.7% in Humera, 7% in Wukro, 4.3% in Lemlem Karl, and 2.9% in Alamata General Hospitals. CONCLUSIONS: Rejected films were found to have been caused by numerous factors including incorrect exposure, poor technical judgment, patient motion, and improper film processing. Hence, strategies need to be developed within medical imaging departments to improve the situation.