ANALYSIS OF CAUSES FOR REJECT OF X-RAY FILMS IN RADIOLOGY DEPARTMENTS OF AHWAZ IMAM KHOMEINI AND GOLESTAN HOSPITALS

Quality assurance in radiologic and radiographic departments is necessary and the analysis of causes for reject of x-ray films has a central role in this respect. Analysis of reject rate of x-ray films is one of the useful indices for assessing the extent of avoidably repeated and unoptimized x-ray examinations. The film reject is rate analysis identifies the factors responsible for the deterioration of radiographic images from which correct solution may be realized. This paper presents the results of investigation on the causes of rejection of x-ray films made at two of the major hospitals affiliated to Ahwaz University of Medical Sciences in year 2000, namely Imam Khomeini and Golestan. A total of 2505 rejected films were analyzed. The overall reject rate was 14.7%, which in comparison with reported reject rates in other studies, was found to be high. While the investigation of 49 studies conducted in other countries indicated that the overall reject rates were between 3 and 15%. Moreover, according to other investigations the overall reject rate should not be more than 8%. The largest proportion of waste films in this project were due to inappropriate selection of exposure factors (42.8%), equipments deficiency (42.6%), faulty positioning (42.5%), artifact (26.15), uncontrolled patients motions (8.1%), and processing defects (3.3%). Statistical Chi-square test showed significant relationship between reject rate and radiographic projections (P<0.01), with the axial projection contributing to the highest percentage (40%). The relationship between reject rate and various positions was significant too (P<0.01), with highest percentage in decubitus position (42.9%). These relationships, for various qualifications, was also significant (P<0.01), with the highest percentage of rejecion pertained to new employed radiographers with associte degrees.