{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:50:21Z","timestamp":1773391821243,"version":"3.50.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"3\u20134","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Reject rate analysis focuses traditionally on frequency rather than radiation impact, thus limiting its alignment with radiation protection goals. This study examined reject rates by body part in digital radiography at a Finnish imaging department and introduced an evaluation of their relative contribution to patients\u2019 additional radiation exposure by calculating a median effective dose-weighted reject rate. The resulting metric may serve as a practical tool to support optimization of radiation burden. The pelvic region and lumbar spine rejected radiographs contributed the highest additional radiation dose, followed by the chest, where the high examination volume outweighed the low relative rejection rate in population-wide dose impact. Extremities contributed negligibly to additional effective dose irrespective of their reject rates, primarily due to a substantially lower radiation sensitivity. These findings emphasize the value of integrating effective dose metrics into reject analysis to better reflect patient risk and enhance quality assurance.<\/jats:p>","DOI":"10.1093\/rpd\/ncaf124","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T12:19:42Z","timestamp":1759234782000},"page":"251-258","source":"Crossref","is-referenced-by-count":0,"title":["Novel reject and effective dose analysis in digital radiography\u2014a Finnish imaging department study"],"prefix":"10.1093","volume":"202","author":[{"given":"Johannes","family":"Ahln\u00e4s","sequence":"first","affiliation":[{"name":"Department of Medical Physics, Wellbeing Services County of Kymenlaakso , Kotkantie 41, 48210 Kotka,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Mari","family":"Vitikainen","sequence":"additional","affiliation":[{"name":"HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital , Haartmaninkatu 4, 00290 Helsinki,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juha I","family":"Peltonen","sequence":"additional","affiliation":[{"name":"HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital , Haartmaninkatu 4, 00290 Helsinki,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauri","family":"Koivula","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Wellbeing Services County of Kymenlaakso , Kotkantie 41, 48210 Kotka,","place":["Finland"]},{"name":"University of Helsinki, Doctoral Programme in Materials Research and Nanoscience , Gustaf H\u00e4llstr\u00f6min katu 2, 00560 Helsinki,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Sinimyrsky","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Wellbeing Services County of Kymenlaakso , Kotkantie 41, 48210 Kotka,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"Pekkarinen","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Wellbeing Services County of Kymenlaakso , Kotkantie 41, 48210 Kotka,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"2026031302435359400_ref1","article-title":"Reject analysis: its role in quality assurance","volume":"50","author":"Watkinson","year":"1984","journal-title":"Radiography."},{"key":"2026031302435359400_ref2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/S1078-8174(98)80027-8","article-title":"X-ray film reject analysis as a quality indicator","volume":"4","author":"Dunn","year":"1998","journal-title":"Radiography."},{"key":"2026031302435359400_ref3","doi-asserted-by":"publisher","first-page":"e13938","DOI":"10.1002\/acm2.13938","article-title":"AAPM task group report 305: guidance for standardization of vendor-neutral reject analysis in radiography","volume":"24","author":"Little","year":"2023","journal-title":"J Appl Clin Med Phys"},{"key":"2026031302435359400_ref4","doi-asserted-by":"publisher","first-page":"6658","DOI":"10.1118\/1.4932623","article-title":"Ongoing quality control in digital radiography: report of AAPM imaging physics committee task group 151","volume":"42","author":"Jones","year":"2015","journal-title":"Med Phys"},{"key":"2026031302435359400_ref5","article-title":"Use of dose quantities in radiological protection. ICRP publication 147","volume":"50","author":"ICRP","year":"2021","journal-title":"Ann ICRP"},{"key":"2026031302435359400_ref6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s10278-009-9236-2","article-title":"One year\u2019s results from a server-based system for performing reject analysis and exposure analysis in computed radiography","volume":"24","author":"Jones","year":"2011","journal-title":"J Digit Imaging"},{"key":"2026031302435359400_ref7","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13244-022-01169-9","article-title":"The assessment of image quality and diagnostic value in X-ray images: a survey on radiographers\u2019 reasons for rejecting images","volume":"13","author":"Kjelle","year":"2022","journal-title":"Insights into Imaging"},{"key":"2026031302435359400_ref8","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1002\/jmrs.343","article-title":"Reject rate analysis in digital radiography: an Australian emergency imaging department case study","volume":"67","author":"Atkinson","year":"2020","journal-title":"J Med Radiat Sci"},{"key":"2026031302435359400_ref9","doi-asserted-by":"publisher","first-page":"2058460115604339","DOI":"10.1177\/2058460115604339","article-title":"Image rejects in general direct digital radiography","volume":"4","author":"Hofmann","year":"2015","journal-title":"Acta Radiol Open"},{"key":"2026031302435359400_ref10","doi-asserted-by":"publisher","first-page":"1687814016644127","DOI":"10.1177\/1687814016644127","article-title":"Guidelines for reducing image retakes of general digital radiography","volume":"8","author":"Lin","year":"2016","journal-title":"Adv Mech Eng"},{"key":"2026031302435359400_ref11","article-title":"Radiological protection in medicine. ICRP publication 105","volume":"37","author":"ICRP","year":"2007","journal-title":"Ann ICRP"},{"key":"2026031302435359400_ref12","article-title":"Radiation risks from medical X-ray examinations as a function of the age and sex of the patient (HPA-CRCE-028)","author":"Wall","year":"2011"},{"key":"2026031302435359400_ref13","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1002\/jmrs.796","article-title":"Multi-centre digital radiography reject analysis for different clinical room use types: the establishment of local reject reference levels for public hospital departments","volume":"71","author":"Serra","year":"2024","journal-title":"J Med Radiat Sci"},{"key":"2026031302435359400_ref14","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1093\/rpd\/ncad301","article-title":"Image reject analysis and rejection causes in digital radiography at a university hospital through estimates of patient doses","volume":"200","author":"Calatayud-Jord\u00e1n","year":"2024","journal-title":"Radiat Prot Dosim"},{"key":"2026031302435359400_ref15","article-title":"Sources, Effects and Risks of Ionizing Radiation: UNSCEAR 2020\/2021 Report","volume-title":"Volume I: Sources. New York: United Nations","author":"United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR)","year":"2022"},{"key":"2026031302435359400_ref16","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.jrras.2022.01.023","article-title":"An assessment of image reject rates for digital radiography in Saudi Arabia: a cross-sectional study","volume":"15","author":"Alashban","year":"2022","journal-title":"J Radiat Res Appl Sci"},{"key":"2026031302435359400_ref17","article-title":"Radiation and nuclear safety authority regulation on the In-service radiation safety of radiation sources and the decommissioning of radiation sources and places of use","author":"Radiation and Nuclear Safety Authority of Finland","year":"2019"}],"container-title":["Radiation Protection Dosimetry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/202\/3%E2%80%934\/251\/67333182\/ncaf124.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/202\/3%E2%80%934\/251\/67333182\/ncaf124.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:44:11Z","timestamp":1773384251000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rpd\/article\/202\/3%E2%80%934\/251\/8518619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":17,"journal-issue":{"issue":"3\u20134","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,3,13]]}},"URL":"https:\/\/doi.org\/10.1093\/rpd\/ncaf124","relation":{},"ISSN":["0144-8420","1742-3406"],"issn-type":[{"value":"0144-8420","type":"print"},{"value":"1742-3406","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]}}}