Quantitative Assessment of the Effects of Scatter Radiation on Image Quality During Extremity Radiography at a Leading Tertiary Hospital in Ghana: An Experimental Pilot Study

Background and Aims: There is a potential increase in scatter radiation during extremity radiography, where radiographers may divide the detector to obtain multiple images on one film. This study assesses the impact of scatter radiation on image quality (IQ) during the dividing receptor technique in extremity radiography at the Korle-Bu Teaching Hospital, Ghana. Methods: An experimental study design was employed. The examinations were performed with a computed radiography system from June 6, 2024, to July 4, 2024, using a dividing receptor technique. Scatter radiation was evaluated as whole-body equivalent dose and surface dose at depths of 10 mm [H_p(10)] and 0.07 mm [H_p(0.07)], respectively. IQ was assessed using ImageJ software v1.54c. Data were analyzed descriptively and inferentially with IBM SPSS v29.0. A p-value < 0.05 was considered statistically significant. Results: The measured scatter doses at H_p(10) and H_p(0.07) for all the examinations were 0.017 ± 0.0015 mSv and 0.0016 ± 0.0020 mSv, respectively. Whereas no statistically significant differences in signal-to-noise ratio (p = 0.53) were found for examinations performed before and after dividing the receptor, the difference in noise was found to be statistically significant (p < 0.001). Different anatomical regions generated varying, but non-significant (p > 0.05), scatter radiations, noise, and signal-to-noise ratios. Pearson correlation tests revealed no statistically significant relationship between the reduced IQ and the measured H_p(10) (p = 0.98) and H_p(0.07) (p = 0.85). Conclusion: The study identified significant differences in noise and non-significant differences in SNR, although the differences did not result from the scatter dose produced from the dividing receptor technique during extremity radiography. Nonetheless, there is a need for radiographers to adopt strategies to reduce the scatter radiation when using the dividing receptor technique. Consequently, we recommend radiation dose optimization techniques such as effective collimation and protocol adjustments during extremity radiography.