Radiology. 1992 Oct; 185(1): 43-6.

Radiography of the lumbosacral spine: characteristics of examinations performed in hospitals and other facilities.

Rueter FG, Conway BJ, McCrohan JL, Slayton RJ, Suleiman OH.

Center for Devices and Radiological Health, Food and Drug Administration, Rockville, MD 20857.

A survey of 523 facilities performing radiographic lumbosacral spine examinations was conducted as a part of the Nationwide Evaluation of X-Ray Trends program in 1987 and 1989. Average patient radiation exposure was measured by using a standard phantom developed by the Center for Devices and Radiological Health of the Food and Drug Administration, U.S. Public Health Service. Data pertaining to radiographic equipment, film processing, and radiographic techniques were obtained. The overall average entrance skin air kerma was 3.65 mGy (420 mR). Ninety-eight percent (496 of 506) of observed facilities used a grid, 89% (466 of 523) had tube potentials between 70 and 89 kVp, and 67% (280 of 418) used screen-film systems with a speed of 400. The most important finding is that underprocessing of film remains a major concern. Thirty-three percent (78 of 234) of the hospitals, 25% of the radiologists in private practice (four of 16), 33% of the nonradiologist private practitioners (27 of 82), and 48% (69 of 143) of the chiropractors underprocessed their film.