Journal of Clinical Pediatrics and Neonatal Care

Neonatal Chest Radiography – Comparison of Exposure Protocols in Canada and Norway

Published on: 2019-06-20


Introduction: Neonates are highly sensitive and vulnerable to ionizing radiation, and as a result, at higher to develop cancer. It is crucial for the radiographer to adhere to the ALARA principle, while preserving image quality. This study aims to collect protocols from different hospitals in Norway and Canada and compare these to the guidelines by the European Commission.
Methods: Neonatal chest protocols from hospitals performing chest x-rays on neonates were collected. Information about exposure parameters, mobile equipment utilized, inherent filtration, added filtration, and the use of a grid or cassette tray were collected. A total of 31 hospitals in Canada and Norway participated in this study.
Results: The majority of hospitals in Canada and all of Norway use DR rather than CR. Most of the protocols for both countries are weight-based. Exposure factors differ between the two countries. Canada generally uses a lower kV than Norway, and Norway uses a lower mAs. Another difference between countries is that Canada typically obtains AP and lateral radiographs of the chest, while Norway performs a single AP projection.
Conclusion: Canada and Norway differ largely in kV and mAs usage as well as the routine projections performed. Canada was found to use protocols that result in higher radiation doses to neonates in comparison to protocols used in Norway. Protocols collected from both countries were compared to the European guidelines and results indicate that there is a need to re-model the Canadian protocols for neonatal chest imaging.


Neonatal chest x-ray; pediatric; radiographic technique; exposure parameters; protocol