This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mutch, S J Articles by Wentworth, S D P Search for Related Content PubMed PubMed Citation Articles by Mutch, S J Articles by Wentworth, S D P

Imaging the neonate in the incubator: an investigation of the technical, radiological and nursing issues

¹ Department of Medical Physics & Clinical Engineering, The Churchill Hospital, Old Road, Headington, Oxford OX3 7L J, ² Department of Medical Physics and Clinical Engineering, Rehabilitation Engineering Unit, Rookwood Hospital, Llandaff, Cardiff CF5 2YN, UK

Correspondence: Steven J Mutch, Department of Medical Physics & Clinical Engineering, The Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ, UK. E-mail: steven.mutch{at}orh.nhs.uk

Modern neonatal incubators incorporate an X-ray tray device into the mattress support structure to facilitate patient examination with minimal disturbance and distress. However, the usual method of examination is to place the image plate directly underneath the baby. Users often cite radiological reasons for not using X-ray trays but modern quantitative evidence is lacking. This work looks at the technical and clinical aspects of imaging neonates in incubators and the impact that these may have in determining the imaging protocol. A number of hospitals were surveyed to determine their current method of examination and the reasons for their preference. Experimental measurements of the radiological impact of using (or not using) the X-ray tray were performed for a range of neonatal incubators. The average dose to the image plate was 5.9 µGy (range 5.4–6.4 µGy) for the "plate on mattress" method and 3.0 µGy (2.0–3.8 µGy) when using the tray — a 49% reduction owing to the mattress support materials. However, when using a computed radiography (CR) imaging system, the image quality differences were marginal. Survey results indicated that nurses preferred to use the tray but that radiographers were reluctant. We conclude that incubator manufacturers could do much to improve the radiological performance of their equipment and we offer recommendations. We also conclude that, with appropriate nurse and radiographer training and the advent of CR imaging systems, use of X-ray tray facilities may optimize imaging of the neonate in the incubator.