Removing Comfort Pads May Reduce Infant X-ray Dose

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Based on a study set to be published in the October issue Academic Radiology, comfort pads that support infants during radiographic studies may firmly hold young patients in place, but they also catch x-ray beams before getting to the detector. Therefore, getting rid of the pads may lead to a considerable reduction in dosage.

“When portable radiographic studies are performed, any beam attenuated/absorbed by the pad occurs after the radiation has already passed through the baby. It is thus unnecessary radiation to the baby, as it does not reach the detector plate that creates the image. Pad removal prior to taking the radiograph may thus be a method of potentially reducing patient radiation,” wrote Amit S. Rattan, MD, and Mervyn D. Cohen, MB, ChB, MD, of Riley Children's Hospital and Indiana University School of Medicine in Indianapolis.

Rather than calculate the exact radiation at the detector plate, the researchers decided to measure the percentage of radiation soaked up or caught by the comfort pad. This was attained by following the exposure index at the detector plate. Since the exposure index rises in a linear fashion as mAs is increased, it can offer an accurate determination of the percent of dose absorbed by the comfort pad. Comfort pads infant x ray

Using thoracic infant phantom models and set exposure factors, the authors calcualted the percentage of radiation absorbed by comfort pads of four different thicknesses, from 0.5 inches to 8 inches.

Results revealed radiation beam attenuation ranged from 12 percent to 72.1 percent, reported Rattan and Cohen. As firstly expected, increased attenuation occurred with increasing pad thickness.

“In clinical use, even more x-ray beams could be wasted through attenuation, as pads are sometimes folded to increase thickness and better support individual patients,” the authors added.

Rattan and Cohen also noted that pad removal could facilitate appropriate dose reduction or improved image quality if exposure factor is kept constant, but some organizations may feel that removing the pads, especially the thinnest pads that absorbed only 12 percent of radiation, may offer more of a risk than benefit if they fully cancel out the loss of support for fragile infants.

“Every neonatal nursery using comfort pads must decide individually how to utilize the results of our study,” the authors concluded.

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