The quality of radiographic imaging at pediatric urgent care centers improves when registered radiology technologists operate the radiographic equipment instead of pediatricians, according to a new study published in the Journal of the American College of Radiology.

“Some pediatric urgent care centers have elected for attending physicians to perform radiographic studies rather than employing dedicated radiography technologists,” wrote lead author J. Herman Kan, MD, with the Texas Children’s Hospital in Houston, and colleagues. “Although most states allow licensed physicians to perform radiographic examinations, training standards vary, potentially leading to increased image quality variability.”

The researchers sought to evaluate whether radiograph quality was impacted at urgent care centers staffed with and without technologists and to assess the utilization of radiography in a pediatric urgent care setting.

In a retrospective case-control study, 235 radiographic exams performed without a radiology technologist (study) and 83 exam were performed with a technologist (control) at six pediatric urgent care centers. Each study was evaluated on field of view, presentation and orthogonal view orientation, using a five-point scale, one being poor and five being best. The studies were also assessed for the incidence of positive results, need for repeated imaging and differences between the initial study and follow-up.

Imaging quality comparisons between both groups for field of view, presentation and orthogonal view orientation were statistically different. The control group performed better than the study group.

• Field of view was approximately 3.9 percent for the study group and 4.2 percent for the control group.
• Presentation was approximately 4.3 percent for the study group and 4.5 percent for the control group.
• Orthogonal view was approximately 4.4 percent for the study group and 4.6 percent for the control group.

Additionally, the incidence of repeat imaging was 4.7 percent for the study group and 2.4 percent for the control group. The discrepancy rates were 3.4 percent for the study group and 2.4 percent for the control group. The incidence for abnormal findings was also higher in the study cohort by approximately 6 percent.

“Our study demonstrates that the quality of radiographic imaging at pediatric urgent care centers is statistically improved when a registered radiology technologist operates the radiographic equipment compared with a pediatrician,” the authors wrote.

The authors added that if it is not financially possible for urgent care centers to staff radiology technologists and regulations permit non-radiology personnel to operate radiographic equipment, physicians should be provided adequate training and supervision.