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Pediatr Radiol. 2014 Mar;44(3):313-21. doi: 10.1007/s00247-013-2824-9. Epub 2013 Nov 27.

Guidelines for anti-scatter grid use in pediatric digital radiography.

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Department of Imaging Physics, The University of Texas, M. D. Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA,



Pediatric radiography presents unique challenges in balancing image quality and patient dose. Removing the anti-scatter grid reduces patient dose but also reduces image contrast. The benefit of using an anti-scatter grid decreases with decreasing patient size.


To determine patient thickness thresholds for anti-scatter grid use by comparing scatter-to-primary ratio for progressively thinner patients without a grid to the scatter-to-primary ratio for a standard adult patient with a grid.


We used Solid Water™ phantoms ranging in thickness from 7 cm to 16 cm to simulate pediatric abdomens. The scatter-to-primary ratio without a grid was measured for each thickness at 60 kVp, 70 kVp and 80 kVp for X-ray fields of view (FOV) of 378 cm(2), 690 cm(2) and 1,175 cm(2) using indirect digital radiography (iDR) and computed radiography (CR). We determined thresholds for anti-scatter grid use by comparing the intersection of a fit of scatter-to-primary ratio versus patient thickness with a standard adult scatter-to-primary ratio measured for a 23-cm phantom thickness at 80 kVp with an anti-scatter grid. Dose area product (DAP) was also calculated.


The scatter-to-primary ratio depended strongly on FOV and weakly on kVp; however DAP increased with decreasing kVp. Threshold thicknesses for grid use varied from 5 cm for a 14 × 17-cm FOV using iDR to 12 cm for an 8 × 10-cm FOV using computed radiography.


Removing the anti-scatter grid for small patients reduces patient dose without a substantial increase in scatter-to-primary ratio when the FOV is restricted appropriately. Radiologic technologists should base anti-scatter grid use on patient thickness and FOV rather than age.

[Indexed for MEDLINE]

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