Abstract：
Temporary feeding tubes are commonly used but may lead to complications if malpositioned. Radiographs are the gold standard for assessing tube position, but clinician concern over radiation risks may curtail their use.
We describe development and use of a reduced dose feeding tube radiograph (RDFTR) targeted for evaluation of feeding tube position.
Age-based abdominal radiograph was adapted to use the lowest mAs setting of 0.32 mAs with field of view between carina and iliac crests. The protocol was tested in DIGI-13 line-pair plates and anthropomorphic phantoms. Retrospective review of initial clinical use compared dose area product (DAP) for RDFTR and routine abdomen, chest, or infant chest and abdomen. Review of RDFTR reports assessed tube visibility, malpositioning, and incidental critical findings.
Testing through a line-pair phantom showed loss of spatial resolution from 2.2 line pairs to 0.6 line pairs but preserved visibility of feeding tube tip in RDFTR protocol. DAP comparisons across 23,789 exams showed RDFTR reduced median DAP 72-93% compared to abdomen, 55-78% compared to chest, and 76-79% compared to infant chest and abdomen (p<0.001). Review of 3286 reports showed tube was visible in 3256 (99.1%), malpositioned in airway 8 times (0.2%) and in the esophagus 74 times (2.3%). The tip was not visualized in 30 (0.9%). Pneumothorax or pneumoperitoneum was noted seven times (0.2%) but was expected or spurious in five of these cases.
RDFTR significantly reduces radiation dose in children with temporary feeding tubes while maintaining visibility of tube tip.
We describe development and use of a reduced dose feeding tube radiograph (RDFTR) targeted for evaluation of feeding tube position.
Age-based abdominal radiograph was adapted to use the lowest mAs setting of 0.32 mAs with field of view between carina and iliac crests. The protocol was tested in DIGI-13 line-pair plates and anthropomorphic phantoms. Retrospective review of initial clinical use compared dose area product (DAP) for RDFTR and routine abdomen, chest, or infant chest and abdomen. Review of RDFTR reports assessed tube visibility, malpositioning, and incidental critical findings.
Testing through a line-pair phantom showed loss of spatial resolution from 2.2 line pairs to 0.6 line pairs but preserved visibility of feeding tube tip in RDFTR protocol. DAP comparisons across 23,789 exams showed RDFTR reduced median DAP 72-93% compared to abdomen, 55-78% compared to chest, and 76-79% compared to infant chest and abdomen (p<0.001). Review of 3286 reports showed tube was visible in 3256 (99.1%), malpositioned in airway 8 times (0.2%) and in the esophagus 74 times (2.3%). The tip was not visualized in 30 (0.9%). Pneumothorax or pneumoperitoneum was noted seven times (0.2%) but was expected or spurious in five of these cases.
RDFTR significantly reduces radiation dose in children with temporary feeding tubes while maintaining visibility of tube tip.
摘要：
背景：通常使用临时饲管，但如果错位可能会导致并发症。射线照片是评估管子位置的黄金标准，但是临床医生对辐射风险的担忧可能会减少它们的使用。
目的：我们描述了用于评估饲管位置的低剂量饲管X光片（RDFTR）的开发和使用。
方法：对基于年龄的腹部X光片进行了调整，以使用最低mAs设置为0.32mAs，视野在隆突和髂峰之间。该方案在DIGI-13线对板和拟人化体模中进行了测试。RDFTR和常规腹部的初始临床使用比较剂量面积产品（DAP）的回顾性回顾，胸部，或婴儿的胸部和腹部。审查RDFTR报告评估管道能见度，错位,和偶然的关键发现。
结果：通过线对体模进行的测试显示，空间分辨率从2.2线对损失到0.6线对，但在RDFTR协议中保持了饲管尖端的可见性。对23,789项检查的DAP比较显示，与腹部相比，RDFTR降低了中位DAP72-93％，与胸部相比，55-78%，与婴儿胸部和腹部相比，为76-79％（p<0.001）。对3286份报告的审查显示，3256份(99.1%)可见管，气道错位8次（0.2％），食管错位74次（2.3％）。在30（0.9％）中未显示尖端。气胸或气腹被发现7次（0.2％），但在其中5例中是预期的或虚假的。
结论：RDFTR可显著降低临时饲管患儿的辐射剂量，同时保持管尖端的可见性。
目的：我们描述了用于评估饲管位置的低剂量饲管X光片（RDFTR）的开发和使用。
方法：对基于年龄的腹部X光片进行了调整，以使用最低mAs设置为0.32mAs，视野在隆突和髂峰之间。该方案在DIGI-13线对板和拟人化体模中进行了测试。RDFTR和常规腹部的初始临床使用比较剂量面积产品（DAP）的回顾性回顾，胸部，或婴儿的胸部和腹部。审查RDFTR报告评估管道能见度，错位,和偶然的关键发现。
结果：通过线对体模进行的测试显示，空间分辨率从2.2线对损失到0.6线对，但在RDFTR协议中保持了饲管尖端的可见性。对23,789项检查的DAP比较显示，与腹部相比，RDFTR降低了中位DAP72-93％，与胸部相比，55-78%，与婴儿胸部和腹部相比，为76-79％（p<0.001）。对3286份报告的审查显示，3256份(99.1%)可见管，气道错位8次（0.2％），食管错位74次（2.3％）。在30（0.9％）中未显示尖端。气胸或气腹被发现7次（0.2％），但在其中5例中是预期的或虚假的。
结论：RDFTR可显著降低临时饲管患儿的辐射剂量，同时保持管尖端的可见性。
