Method of determining technique from weight and height to achieve targeted detector exposures in portable chest and abdominal digital radiography

This study presents a methodology to develop an X‐ray technique chart for portable chest and abdomen imaging which utilizes patient data available in the modality worklist (MWL) to reliably achieve a predetermined exposure index (EI) at the detector for any patient size. The method assumes a correlation between the patients’ tissue equivalent thickness and the square root of the ratio of the patient's weight to height. To assess variability in detector exposures, the EI statistics for 75 chest examinations and 99 abdominal portable X‐ray images acquired with the new technique chart were compared to those from a single portable unit (chest: 3877 images; abdomen: 200 images) using a conventional technique chart with three patient sizes, and to a stationary radiography room utilizing automatic exposure control (AEC) (chest: 360 images; abdomen: 112 images). The results showed that when using the new technique chart on a group of portable units, the variability in EI was significantly reduced (p < 0.01) for both AP chest and AP abdomen images compared to the single portable using a standard technique chart with three patient sizes. The variability in EI for the images acquired with the new chart was comparable to the stationary X‐ray room with an AEC system (p > 0.05). This method could be used to streamline the entire imaging chain by automatically selecting an X‐ray technique based on patient demographic information contained in the MWL to provide higher quality examinations to clinicians by eliminating outliers. In addition, patient height and weight can be used to estimate the patients’ tissue equivalent thickness.