Introduction: Conventional X-ray imaging of the cervical spine is one of the primary methods for diagnosing cervical spine injuries. The quality of radiographs depends on multiple factors such as the experience of the radiologic technologist, the characteristics of the equipment and imaging techniques. One method to improve image quality is the use of a radiographic grid, which reduces scattered radiation and improves contrast but increases the radiation dose to the patient. Purpose: The aim of the study was to investigate the impact of removing the radiographic grid during lateral cervical spine imaging on the radiation dose and image quality. Methods: The study was conducted in two parts – the first included measurements on a phantom, while the second involved clinical measurements on patients. A descriptive method and a prospective study were employed, with radiographs evaluated by standardized image quality assessment criteria. Radiation dose was measured with a dose area product (DAP) meter. Results: The findings indicate that the removal of the grid led to a statistically significant (p < 0,001) reduction in radiation dose ( 63 % lower dose), without compromising the diagnostic quality of radiographs (p = 0.192). No statistically significant differences (p = 0.226) in the visualization of anatomical structures were identified. The visualization of anatomical structures remained comparable, suggesting that diagnostic image quality can be maintained even without the use of a grid. Discussion and conclusion: Based on these results, gridless imaging presents an effective alternative that optimizes radiological protocols by reducing patient radiation exposure while preserving image quality. Implementing such an approach could significantly contribute to improving patient safety in radiological examinations.
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