Dimas Skam Joseph



Reject image analysis is a quality control check periodically carried out to ensure that optimally diagnostic images are produced. The overall aim ensures that patient radiation dose due to repeat exposure is drastically reduced. In order to ensure continuous optimal quality assurance of the imaging services provided by radiographers to patients, quality control checks such as reject image analysis are put in place to monitor the quality assurance program. The reject image analysis is not a new concept as it has continuously been used by radiographers to check reasons for repeat exposures and the anatomical part of the body mostly affected.


An audit of retrospectively acquired radiographic images of a total of 1740 patients collected from January to March 2020 was performed by two senior radiographers. A data collection chart was used to collect the data according to the causes of repeat exposures with respect to the anatomical body part examined and then the reject image rate was calculated.


The reject image rate (RIR) for January, February and March 2020 are 9.98%, 11.57% and 9.04% with image cut as the major reason for the reject having 3.7%, 3.35% and 4.06% RIR in the respective months. The overall RIR from January to March 2020 is 9.77%.


Though the overall RIR is within recommended limits, continuous reject image analysis will aid in ensuring optimally diagnostic images are continuously produced with minimal repeat exposures and regular continuous professional development (CPD) is recommended for the Radiographers and Radiographer Assistants in order for them not to become rusty with time. The implications for practice is that low RIR is an indicator that optimal radiography services are rendered and also that patients are not exposed to unnecessary radiation. The choice of CPD should be tailored towards the periodic outcome of the reject image analysis especially for young radiographers. As such, a reject image analysis wallet for each radiographer is encouraged in order to identify individual radiographers’ deficiencies.

Keywords: Reject image rate (RIR), repeat exposure, quality control checks, radiation dose,  radiographers

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