A pilot study evaluating erect chest imaging in children, using the Lodox Statscan digital X-ray machine

Background. Chest radiography accounts for a significant proportion of ionising radiation in children. The radiation dose of radiographs performed on the Lodox Statscan system has been shown to be lower than that of a computed radiography (CR) system. The role of the Lodox Statscan (subsequently referred to as the Statscan) in routine erect chest radiography in children has not been evaluated. Objective. To evaluate the image quality and diagnostic accuracy of erect paediatric chest radiographs obtained with the Statscan and to compare these with conventional erect chest images obtained with a CR system. Materials and methods. Thirty-three children with suspected chest pathology were enrolled randomly over a period of 3 months. Erect chest radiographs were obtained with the Statscan and a Shimadzu R-20J X-ray machine coupled with a Fuji FCR 5000 CR system. Image quality and diagnostic accuracy and diagnostic capability of the two modalities were evaluated and compared. Results. The erect Statscan allowed superior visualisation of the 3 major airways. Statscan images, however, demonstrated exposure and movement artifacts, with hemidiaphragms and ribs most prone to movement. Bronchovascular clarity was also considered unsatisfactory on Statscan images. Conclusion. The Statscan has limitations in erect chest radiography in terms of movement artefacts, exposure fluctuations, and poor definition of lung markings. Despite this, the Statscan allows better visualisation of the major airways, equivalent to a 'high kV' film, at a fraction of the radiation dose, which supports the finding of an earlier study evaluating Statscan images in trauma cases, where the images were taken supine. The Statscan has great potential in assisting in the diagnosis of child-hood tuberculosis where airway narrowing occurs as a result of nodal compression.