Localiser radiographs in CT: Current practice, radiation dose, image quality and clinical applications

Introduction

Survey or localiser radiographs are integral to CT imaging. However, the diverse functions and roles of the localiser radiograph are often obscure to radiographers and radiologists. This scoping review reports the full scope of localiser radiograph use and function in contemporary CT imaging.

Methods

A scoping review was performed. A systematic literature search was conducted using four databases: MEDLINE, CINAHL, Emcare and Scopus from January 2013 to December 2023. Data extraction was conducted by two review authors and validated by a third reviewer. Thirty-six studies were included in this review.

Results

Three major themes emerged: radiation dose management, image quality considerations and clinical protocol applications. Specifically, the number, order of selection and directions of localiser radiographs significantly impact patient dose and image quality; which are additionally impacted by off-centre patient positioning, which can influence the accuracy of body size estimates and CT numbers. Finally, the optimal selection of localiser radiographs, including exposure parameters (kVp, mAs), can be a part of clinical task-based imaging protocol optimisation.

Conclusions

The utilities of localiser radiographs in CT imaging are varied. It is salient that radiographers and radiologists understand their role and the impacts of poor application to ensure that radiation dose is minimised and image quality maximised through correct use. Radiographers and radiologists should also be aware of the impact of poor patient positioning on ACTM function, dose and image quality. Additionally, localiser radiographs should be used for clinical task-based protocol optimisation.

Implications for practice

The number, order of selection, direction, patient off-centring, and exposure parameters must be considered when utilising localiser radiographs as they impact dose, image quality, and protocol applications. It is essential for radiographers and radiologists to understand these impacts.