Increasing film-focus distance (FFD) reduces radiation dose for x-ray examinations

Increasing film-focus distance (FFD) from the traditional 100 cm has been shown to be an effective method of reducing dose whilst maintaining image quality. In particular, previous work increasing the FFD from 100 to 130 cm for lumbar spine examinations demonstrated an effective dose reduction of 44%. Objective. The current study continues on from this work by investigating the dose-reducing efficacy of this FFD change for pelvis X-ray examinations. Materials and methods. Dose measurements at 100 and 130 cm using thermoluminescent dosemeters were undertaken using an anthropomorphic phantom and patients. Image quality was assessed using CEC anatomical criteria and psychophysical tests. Results. The results showed that increasing the FFD results in a reduction in effective dose of 33%, with no change in image quality. The data provided in this and previous studies demonstrate the need for rapid implementation of this simple cost-effective procedure across imaging departments, leading to an important reduction in collective dose. Conclusion. The CEC recommendation of using 115 cm FFD for a number of procedures, although useful compared with 100 cm, undervalues by a factor between 2 and 3 the potential of this dose-reducing tool.