Lines, Lungs, and Landmarks: Evaluating Image Quality in Mobile Neonatal Chest Radiographs

 

Background: 

Mobile chest radiographs are vital in NICU settings for monitoring respiratory status, evaluating lung pathology, and verifying the placement of lines and tubes in critically ill neonates who cannot be moved to the radiology department. Due to patient fragility, small size, and the limitations of mobile equipment, these radiographs often suffer from poor positioning, suboptimal coverage, and inadequate image quality, which can compromise diagnostic accuracy.

Recommendations:

Familiarize radiographers on correct centering, positioning, and collimation for neonatal chest X-rays. Encourage the placement of anatomical marker in primary beam under feasible circumstances. Use a real time QA checklist at bedside to check anatomical marker, positioning, collimation and NGtube tip visibility. Consider introducing a real-time QA prompt system at image acquisition stations with periodic image reviews. Encourage collaborative practice between radiographers and NICU staff to ensure optimal patient handling and radiographic positioning.