A Study of Repeat Digital Chest X-ray Radiography at Ubon Ratchathani Cancer Hospital

Abstract

        Chest X-ray is one of the most commonly performed diagnostic imaging procedures. However, repeat X-rays remain a problem affecting service quality, increasing unnecessary radiation exposure for patients. The purpose of this study was to determine the repeat rate of chest X-ray, identify associated factors, and provide baseline data for developing strategies to reduce repeat examinations in digital radiography systems. This study included 4,841 patients who underwent chest X-ray at Ubon Ratchathani Cancer Hospital between October 1, 2024 and December 31, 2024. Data were collected from the Picture Archiving and Communication System (PACS), the Hospital Information System (HIS), and general digital radiography systems (1,000 mA). The results showed that 174 repeat examinations were performed, representing a repeat rate of 3.59%. The most common cause was poor inspiration (101 cases, 58.05%), followed by image artifacts (45 cases, 25.86%) and positioning error (18 cases, 10.34%). Statistical analysis demonstrated that body mass index (BMI), nationality, and patient type were significantly associated with repeat chest X-ray examinations, whereas gender and age were not associated with repeat chest X-ray examinations. In conclusion, repeat chest X-rays were primarily associated with workflow factors, including patient communication, patient preparation, pre-examination checking, and radiological technologist skills. These factors are modifiable. Improving these workflow processes and continuously monitoring repeat X-ray may reduce repeat examinations, decrease unnecessary radiation exposure, improve image quality and enhance the quality of radiographic services.