Radiographic repeat analysis in four public hospital radiology departments in the Souss-Massa region, Morocco: A cross-sectional study.

INTRODUCTION

This study presents a radiographic repeat analysis conducted in public hospitals in the Souss-Massa region of Morocco. It aimed to assess repeat rates, identify the most frequent causes of image repetition and the most affected anatomical regions, and examine variations in recurrence rates.

METHODS

A cross-sectional study was conducted during March and April 2025 in four public hospitals in the Souss-Massa region of Morocco. The number of acquired and repeated images was recorded using a standardized observation grid, supplemented by repeated image extraction for retrospective analysis. Descriptive statistics and chi-square tests were used to assess repeat rates, associated causes, anatomical regions involved, and variations by hospital and day of the week.

RESULTS

Of the 15,493 radiographic images analyzed, 1063 were repeated, resulting in an overall repeat rate of 6.86%, which falls within the acceptable range recommended by the American Association of Physicists in Medicine (AAPM). The highest specific repeat rate was observed at Hospital 2 (11.94%), followed by Hospital 1 (4.63%), Hospital 4 (4.33%), and Hospital 3 (3.92%). The most frequently repeated examinations were chest, pelvis, abdomen, lumbar spine, and shoulder. Across all examination types, the main causes included positioning errors, metallic artifacts, collimation errors, and under- or over-exposure. Daily variability in repeat rates was also observed.

CONCLUSION

Although the repeat rate was within acceptable limits, indicating reasonably adequate radiographic image production, variations between hospitals and the predominance of preventable professional errors highlight the need for improved technical consistency.

IMPLICATIONS FOR PRACTICE: Implementing standardized protocols, extending repeat-rate assessment and regular monitoring, establishing a reference threshold, improving understanding of human and organizational factors, and harmonizing image acceptance criteria would help reduce repetition and strengthen consistency in assessments across professionals.