Comparison of anteroposterior and posteroanterior projection in erect pelvic radiography

Hajdarević, Amir (author), Mekiš, Nejc (author)

Purpose: The X-ray examination of the pelvis is one of the procedures with the highest radiation dose and the most common X-ray examination. For this reason, this study investigated whether the alternative posteroanterior (PA) projection can be used instead of the established anteroposterior (AP) projection to perform pelvic radiography in an erect position. Methods: The study was conducted in a clinical setting on 100 patients who were referred to erect pelvic radiography. The patients were randomly divided into two equal groups of 50; the first group was imaged in the AP projection, and the second group in the PA projection. Weight and height were measured for each patient, from which the body mass index was calculated. During imaging, the source-to-patient was measured, and the tube voltage, tube current and time product, Dose Area Product (DAP), source-to-image receptor distance, and primary field size were collated. Based on these data, the entrance surface dose (ESD) and the effective dose, as well as the dose to selected organs, were calculated. In addition to measured dosimetric values, image quality was also assessed by three experienced radiologists using ViewDEX 2.57 software. Results: No statistically significant differences were found between the AP and PA projection of erect pelvic radiography for DAP and ESD. On the other hand, a statistically significant difference of 51.5 % (p < 0.001) was found when comparing the effective dose. There were no statistically significant differences between the image quality of the radiographs taken in the PA in AP projection. Conclusion: Based on the above results, we can conclude that PA projection should be the method of choice when performing an erect pelvic radiography due to a significant decrease in effective dose.

• Language: English
• Keywords: pelvic radiography, dose reduction, image quality
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: ZF - Faculty of Health Sciences
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: 6 str.
• Numbering: Vol. 222, art. 111859
• PID: 20.500.12556/RUL-169047
• UDC: 616-07
• ISSN on article: 1872-9800
• DOI: 10.1016/j.apradiso.2025.111859
• COBISS.SI-ID: 235212803
• Publication date in RUL: 08.05.2025

Record is a part of a journal

• Title: Applied radiation and isotopes
• Publisher: Elsevier
• ISSN: 1872-9800
• COBISS.SI-ID: 23195141

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.