Back to Basics: A Review of Chest Digital Radiography

George Tsoukatos, BPS, R.T. (R)(ARRT)®*

Address correspondence to: George Tsoukatos, BPS, R.T. (R)(ARRT)^®*, Radiology Support Services, PO Box 215, Germantown, NY 12526. E-mail: radiologytechnique@gmail.com.

Disclosure Statement: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Chest radiography remains the foundation of cardiothoracic imaging despite the diagnostic superiority and increasing availability of cross-sectional imaging techniques. The main advantages of chest radiographs are the speed at which the images can be acquired and interpreted, the low cost, availability, and low radiation exposure compared to cross-sectional imaging modalities. It also gives healthcare providers a great deal of pertinent clinical information. Upright chest radiographs still play an important role as a fast tool to rule out various cardiothoracic and pulmonary radiologic findings or to monitor treatment response. However, digital radiography (DR) has largely replaced film-screen radiography, which has led to the development of advanced imaging techniques such as dual-energy subtraction, digital tomosynthesis computer-aided detection (CAD), and dynamic imaging. Clinical practice guidelines and best practices have been developed for radiologic technologists (RTs) to ensure that optimal image quality is attained using the minimum appropriate radiation dose. These guidelines make practical and specific recommendations for many aspects of DR, including image acquisition, the use of radiation dose indicators, image processing and display, as well as data sharing, transmission, and storage. It is important that RTs work closely with radiologists, medical physicists, and other healthcare professionals to ensure the accuracy and safety of DR systems and their patients. This continuing education (CE) course provides a review of conventional analog chest radiography in addition to focusing on current types of chest DR techniques, including computed radiography, indirect flat panel detectors, direct flat-panel detectors, and lesser utilized slot-scanning charge-coupled device technology. Included in this course are proper patient and equipment positioning techniques for stationary and mobile chest radiography, normal anatomy, and common pathologic findings.