to the patient as possible while still maintaining a quality diagnostic image.

One of the easiest

and often overlooked ways of decreasing patient dose is through the use of collimation. By
decreasing the size of the x-ray field to only the area of interest, we can reduce the amount of
scatter radiation and overall patient dose. Limiting radiation exposure is extremely critical when
imaging pediatric patients and young children because they are more sensitive to radiation than
adults.
Research has shown that some radiologic technologists may be using post processing
masking as an alternative to proper collimation and that some of the field sizes used may even
be larger than the film cassette. Some technologists may argue that it is better to leave
collimation open than to have to repeat an image because anatomy was clipped. Before the use
of digital x-rays, radiographers were required to process their films before they were able to
view them. This process took a lot more time than digital x-rays do today which may have
caused radiographers to take extra time while positioning to decrease the chance of repeating.
In order to be professional and exemplary radiographers we should strive to use proper
positioning so that we are able to collimate on all exams without the fear of clipping anatomy.
We should not use the newer digital post processing as a crutch. Post processing collimation
does not reduce patient dose and does not improve image quality.

This left lateral chest x-ray shows what proper collimation should look like with the yellow
border. There is no need to include all of the extra anatomy as it only attributes to patient dose.

This radiograph shows proper collimation of a pediatric chest x-ray.

Not collimating enough is generally the main concern, but sometimes excessive collimation may
become a problem. After an imaging plate has been sent through the reader there is a chance
for field recognition errors which result in an image that is too dark or too light. These errors may
occur if a technologist does not collimate enough or if they collimate too much. To avoid this
field recognition error we must ensure that the exposure is covering at least 30% of the imaging
plate. This may require the use of a 10x12 imaging plate rather than a 14x17 in some exams
where greater collimation is needed.

This image shows an axial projection of the shoulder. This image was taken with excessive
collimation (or collimation that covered less than 30% of the imaging plate). This resulted in a
field recognition error that produced excessive density to the part exposed.

References
Fauber, T.L., & Dempsey, M.C. (2013). X-ray Field Size and Patient Dosimetry. Radiologic
Technology, 85(2), 155-161.
Sandridge, T.G. (2013). Excessive Collimation. Radiologic Technology, 84(3), 305-306.