Table 2.

Radiographer criteria for image quality assessment of chest X-ray images (based on [12] and local experience)

Criteria	Response
Anatomy
1. Both lungs, from apices to costophrenic angles, are included within the exposure field	Yes/No
2. At least nine posterior ribs are visualised above the diaphragm	Yes/No
3. The image receptor was positioned crosswise or lengthwise correctly to accommodate the required anatomy	Yes/No
Collimation
4. Collimation is demonstrable and sufficient	Yes/ No (over collimated)/ No (under collimated)
Positioning
5. The image is demonstrated towards the centre of the image receptor to facilitate required anatomy	Yes/No
6. Seventh thoracic vertebra is at the centre of the exposure field	Yes/No
7. Distances from vertebral column to sternoclavicular ends are equal	Yes/No
8. Lengths of the left and right corresponding posterior ribs are equal	Yes/No
9. Posterior ribs demonstrate a gently superiorly bowed contour	Yes/ No (horizontal)/ No (vertical)
10. Manubrium is approximately at the level of the fourth thoracic vertebra with around 2.5 cm of apical lung field visible above the clavicles	Yes/No
11. Mandible is not in the exposure field	Yes/No
Motion
12. The lung markings, diaphragm, heart borders, hilum, great vessels and bony cortical outlines are sharply defined	Yes/No
Exposure
13. The Exposure Index number obtained at the ideal level or within the acceptable parameters for the digital system	Yes/Under/Over
14. The projection demonstrates quantum noise over the region of interest	Minimal/Some/Excessive
15. The projection demonstrates saturation	Yes/No
16. Thoracic vertebrae, posterior ribs and lines/tubes are faintly seen through the heart and mediastinal structures	Yes/No
17. Vascular lung markings are visible throughout the lung fields, including through the heart shadow and below the diaphragm	Yes/No
Artifacts
18. Anatomical or external artifacts are removed where possible	Yes/No