ABSTRACT
Medical image quality is the attribute of an image that affects the accuracy with which diagnostically useful detail can be seen on it. Poor quality radiographs can impede diagnosis and lead to increased radiation dose to patients through repeat examinations. Some guidelines have been laid down by the European Union in order to determine the quality of lumbar spine radiographs. The aim of this research was to evaluate the image quality of lumbar spine radiographs produced in a diagnostic centre using European Union guidelines (CEC criteria) while also checking the rate of fulfilment of some radiographic technical parameters. A retrospective study was done of 105 AP lumbar spine radiographs and their corresponding lateral radiographs all obtained from the electronic archive of the centre. The image quality of the radiographs was independently evaluated by two experienced radiographers by checking the rate of fulfilment of CEC criteria, also the fulfilment of radiographic technical parameters was also noted. Inter-reader reliability between the two readers was determined by Cohen Kappa statistics. Descriptive statistics such as frequency and percentages were generated from the result and were analyzed using statistical package for social sciences (version 21). The mean Kappa value showing inter-reader agreement for AP and lateral lumbar spine radiographs was observed to be 0.61 and 0.62 respectively, this indicated a substantial agreement between the two readers. The score/rating for a radiograph was determined by the mean value of the two readers’ score/rating for that radiograph. The AP radiographs had a 58.9% quality in terms of compliance to the CEC criteria while lateral radiographs had a 53.5% quality. In terms of gender, male radiographs had a better image quality than female radiographs. For the technical parameters, patient rotation was an area of concern in lateral radiographs as 51.4% of them were rotated, both AP and lateral radiographs were not adequately penetrated. This result showed the need for the implementation of a quality control system in the institution and also the need for proper optimisation of radiographic procedures like patient positioning and technique in order to produce better images.