Declaration

I certify that;
1. Entirely the effort in this final year project is substantially my own, and to the range
that any part of this work is not my own. I have point out that it is not mine by fully
own up in accordance with the regular referring practice of the discipline.
2. I have recite and understood the University Technology MARA student plagiarism.
3. I apprehend that failure to fulfill with the student plagiarism: Coursework Policy and
Procedure can lead to the Universities end proceedings againts me for possible
student misconduct under `Peraturan Akademik Universiti Teknologi MARA 2003,
para 2.13.6.3 regarding plagiarism.

Nor Hizal Bin Basiron

Matrix no:2011429446
Bachelor In Medical Imaging (HONS)
Faculty Of Health Sciences
University Technology MARA
Puncak Alam, Selangor.

..................................................
Date : 01 Disember 2014.

Acknowledgement
Firstly, Alhamdulillah thanks to Allah for the strengths and His blessing in completing
for this final year project. High appreciate to my supervisor, Associate Professor Dr Haji
Sulaiman Md Dom for his supervision and constant supported. His invaluable help of
constructive comments and suggestions throughout the experimental and thesis works
have contributed to the success of this final year project.
Also, I would like to express my appreciation to all lectures and Medical Imaging
Department staff for their support and help towards my study. Not forget my
acknowledgement goes to all the radiographers of Diagnostic Imaging Department of
Hospital Bentong, Pahang and also the radiographers and radiologists of Diagnostic
Imaging Department of Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang for their cooperations and supports during my study.
Last but not least, my deepest gratitude goes to my beloved parents and my wife
Madam Rohaya binti Abdullah and my children for their endless love, prayers and
encouragement and also to those who directly and indirectly contributed in this study.
Thank you very much.

Table of Contents
DECLARATION

ACKNOWLEDGEMENT

ii

TABLE OF CONTENTS

iii

LIST OF FIGURES AND TABLES

LIST OF ABBREVIATIONS vi
ABSTRACT

vii

CHAPTER 1 : INTRODUCTION

1.1 Background 1
1.2 Problem statement 2
1.3 Rational of the study

1.4 Research objectives 3

1.4.1

General objective

1.4.2

Specific objective

1.5 Research Hypothesis

CHAPTER 2 : LITERATURE REVIEW

2.1 Introduction 5
2.2 Pelvis Imaging

2.3 Kilovoltage peak (kVp)

2.4 Computed Radiography

2.5 Imaging quality

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CHAPTER 3 : METHODOLOGY

11

3.1 Introduction 11
3.2 Research Design

12

3.3 Study location

12

3.4 Scope of research

13

3.4.1

Inclusion criteria

13

3.4.2

Exclusion criteria

13

3.5 Imaging equipment 14

3.6 Phantom and Imaging technique 15
3.7 Ethical consideration

16

3.8 Method for evaluation the data analysis 16

3.8.1

Image Criteria Score17

3.8.2

Established questionnaire 17

3.8.3

Statistical analysis 17

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TABLES
Table 2.1 : Image quality criteria used for evaluating the AP Pelvis 1
Table 4.1 : The images will be evaluated using Image Criteria Scoring (ICS)
Table 4.2 : The equipment used in study

Table 4.3 : Set of the exposure factors and number of the image taken
Table 2.1 : Mean value of criteria score for each kVp

Table 4.1 : Frequency of image preferred by respondents 2

Table 4.2 : One way ANOVA 3
Table 4.3 :

LIST OF ABBREVIATIONS

kVp

kilovoltage peak

AP

Anteroposterior

CR

Computed Radiography

ICS

Image Criteria Scoring

mAs

milliampere-seconds

AEC

Automatic Exposure Control

CEC

Committee European Commission

EI

Exposure Indicator

ATLS

Advanced Trauma Life Support

HoSHAS

Hospital Sultan Haji Ahmad Shah

SPSS

Statistical Package For The Social Sciences

ALARP

As Low As Reasonably Practicable

BCO

Bony Cortical Outline

ALARA

As Low As Reasonably Achievable

IP

Image Plates

RIS

Radiology Information System

UiTM

Universiti Teknologi MARA

CD

Compact Disc

HSD

Honestly Significant Difference

6

ABSTRACT

Purpose : The main of this study is to investigate the optimization of kVp values select for
Anteroposterior (AP) Pelvis projection using Computed Radiography (CR).

Methodology: The study was an experimental study using the pelvic phantom. The
experimental study done in Medical Imaging Labarotary, UiTM, Puncak Alam. Five images of
pelvis radiograph were obtained at 60kV, 69kV, 79kV, 91kV, and 105kV. The images were
displayed randomly without any information about kVp used. Each radiograph was labelled
with A, B, C, D, and E. The cilinical images quality was assessed by radiographers and
radiologists at Hospital Bentong and Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang by
using image criteria score (ICS) method.

Results: The descriptive analysis showed that, the highest mean value was 69 kVp (4.58
0.46) and the lowest mean value was 105kVp (3.34 0.79). The results indicated that the
mean value was decreased with increasing of kVp value. Therefore, the optimization of kVp
value for AP pelvis projection at the 69 kVp. The one way ANOVA and Paired Samples TTest were applied and found that there were significant difference between variable since the
p value < 0.05 (0.000).

Discussion: The present study showed that criteria score mean value 3 and above offered
high quality to the AP pelvis imaging and suitable for diagnosis purpose. All the kVp value
( 60 kVp, 79 kVp, 91 kVp, and 105 kVp) showed mean value were 3 except 69 kVp showed
mean value was 4. Therefore, it was indicated that 69 kVp has high image quality and
acceptable for diagnosis purposes. So, the optimization of kVp value select for
Anteroposterior (AP) Pelvis projection using Computed Radiography (CR) at 69 kVp.
7

Conclusion: All criteria can be observed by using all kVp setting. Only one image has high
image quality. In term of good visualization of criteria, the present study had found that by
using 69 kVp can give better visualization of criteria. Indirectly, the optimization of kVp value
select for Anteroposterior (AP) Pelvis projection using Computed Radiography (CR) at 69
kVp. Even though high kVp can be reduced patient dose, but the image quality is not evident
compared to low exposed factor used.

Key word: kVp, pelvis radiograph, image quality, computed radiography

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