Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience
Abstract Introduction Quality assurance (QA) in medical imaging ensures consistently high‐quality images at acceptable radiation doses. However, the applicability of the chest X‐ray (CXR) QA tool in images with pathology, particularly infectious diseases like COVID‐19, has not been explored. This st...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Journal of Medical Radiation Sciences |
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| Online Access: | https://doi.org/10.1002/jmrs.852 |
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| author | Peter O'Reilly Dania Abu Awwad Sarah Lewis Ernest Ekpo Warren Reed |
| author_facet | Peter O'Reilly Dania Abu Awwad Sarah Lewis Ernest Ekpo Warren Reed |
| author_sort | Peter O'Reilly |
| collection | DOAJ |
| description | Abstract Introduction Quality assurance (QA) in medical imaging ensures consistently high‐quality images at acceptable radiation doses. However, the applicability of the chest X‐ray (CXR) QA tool in images with pathology, particularly infectious diseases like COVID‐19, has not been explored. This study examines the utility of the European Guidelines for image quality in QA of CXRs with varying severity and types of infectious disease. Methods A convenient sampling methodology was employed to recruit 25 participants (qualified radiographers: n = 13 and 4th‐year undergraduate radiography students: n = 12) to evaluate 70 CXR images using the European Guidelines for image quality in CXRs. The image dataset comprised of COVID‐19 and non‐COVID‐19 cases, which were randomly selected to reflect routine clinical practice variability. Participants independently rated image quality based on 10 criteria in the European guidelines on quality criteria for CXRs using a six‐point Likert scale. Image quality ratings of normal and pathological CXR images were compared using a Kruskal–Wallis test. Spearman's ranked order correlation was used to assess the association between quality criteria ratings. Results CXRs with no pathology or non‐COVID pathologies exhibited statistically higher total QA scores compared to CXRs with COVID‐19 and indeterminate COVID‐19 (P < 0.001). This trend was evident across various QA factors, especially those associated with patient inspiration. Higher levels of infection corresponded to lower QA ratings. No differences were found between different pathologies regarding the medial border of the scapulae being outside the lung fields. Conclusions Severe pathology negatively impacts the technical quality of CXRs with COVID‐19 features without necessarily affecting their diagnostic value. The findings emphasise the need to prioritise diagnostic ability over technical quality when evaluating CXRs exhibiting diffuse signs of pathology. |
| format | Article |
| id | doaj-art-d8a5da3c170f4ac498badc4a28c9fb32 |
| institution | Kabale University |
| issn | 2051-3895 2051-3909 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj-art-d8a5da3c170f4ac498badc4a28c9fb322025-08-20T03:25:20ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092025-06-0172223424310.1002/jmrs.852Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experiencePeter O'Reilly0Dania Abu Awwad1Sarah Lewis2Ernest Ekpo3Warren Reed4Discipline of Medical Imaging Sciences, Faculty of Medicine and Health University of Sydney Camperdown New South Wales AustraliaDiscipline of Medical Imaging Sciences, Faculty of Medicine and Health University of Sydney Camperdown New South Wales AustraliaSchool of Health Sciences Western Sydney University Parramatta New South Wales AustraliaDiscipline of Medical Imaging Sciences, Faculty of Medicine and Health University of Sydney Camperdown New South Wales AustraliaDiscipline of Medical Imaging Sciences, Faculty of Medicine and Health University of Sydney Camperdown New South Wales AustraliaAbstract Introduction Quality assurance (QA) in medical imaging ensures consistently high‐quality images at acceptable radiation doses. However, the applicability of the chest X‐ray (CXR) QA tool in images with pathology, particularly infectious diseases like COVID‐19, has not been explored. This study examines the utility of the European Guidelines for image quality in QA of CXRs with varying severity and types of infectious disease. Methods A convenient sampling methodology was employed to recruit 25 participants (qualified radiographers: n = 13 and 4th‐year undergraduate radiography students: n = 12) to evaluate 70 CXR images using the European Guidelines for image quality in CXRs. The image dataset comprised of COVID‐19 and non‐COVID‐19 cases, which were randomly selected to reflect routine clinical practice variability. Participants independently rated image quality based on 10 criteria in the European guidelines on quality criteria for CXRs using a six‐point Likert scale. Image quality ratings of normal and pathological CXR images were compared using a Kruskal–Wallis test. Spearman's ranked order correlation was used to assess the association between quality criteria ratings. Results CXRs with no pathology or non‐COVID pathologies exhibited statistically higher total QA scores compared to CXRs with COVID‐19 and indeterminate COVID‐19 (P < 0.001). This trend was evident across various QA factors, especially those associated with patient inspiration. Higher levels of infection corresponded to lower QA ratings. No differences were found between different pathologies regarding the medial border of the scapulae being outside the lung fields. Conclusions Severe pathology negatively impacts the technical quality of CXRs with COVID‐19 features without necessarily affecting their diagnostic value. The findings emphasise the need to prioritise diagnostic ability over technical quality when evaluating CXRs exhibiting diffuse signs of pathology.https://doi.org/10.1002/jmrs.852COVID‐19CXRdiagnostic imagingimage quality and diagnostic valueimage quality evaluationmedical imaging standards |
| spellingShingle | Peter O'Reilly Dania Abu Awwad Sarah Lewis Ernest Ekpo Warren Reed Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience Journal of Medical Radiation Sciences COVID‐19 CXR diagnostic imaging image quality and diagnostic value image quality evaluation medical imaging standards |
| title | Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience |
| title_full | Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience |
| title_fullStr | Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience |
| title_full_unstemmed | Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience |
| title_short | Assessing chest radiographic quality and the influence of COVID‐19 pathology: the Australian experience |
| title_sort | assessing chest radiographic quality and the influence of covid 19 pathology the australian experience |
| topic | COVID‐19 CXR diagnostic imaging image quality and diagnostic value image quality evaluation medical imaging standards |
| url | https://doi.org/10.1002/jmrs.852 |
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