A unique secondary collimation tool for mobile neonatal diagnostic radiography: The Baby Cone

Introduction Contact lead shielding is not a viable radiation protection option in neonatal radiography because of the risks associated with infection control. Instead, diagnostic radiographers rely on optimal exposure factor selection and main beam collimation. However, effective collimation is challenging due to the small neonatal size and the ninety-degree structural limitations of main beam collimators. This study aimed to evaluate the Baby Cone, a secondary collimation device designed for mobile neonatal radiography, and to assess its impact on entrance skin dose. Methods This observational study incorporated simulation research strategies for dose measurements. The Baby Cone was introduced in two hospitals across 120 neonatal examinations. Entrance skin dose was measured at six anatomical regions per examination. The entrance skin dose values were compared with and without the Baby Cone. Results The Baby Cone demonstrated improved collimation, resulting in smaller field-of-view compared to standard collimation. Statistically significant reductions in entrance skin dose were observed across all examinations when the Baby Cone was used. For the chest at the centering point, entrance skin dose values decreased from 77.5 μGy–58.2 μGy to 68.2 μGy–51.9 μGy with the Baby Cone (p < 0.0001). For the chest–abdomen combination at the centering point, entrance skin dose values reduced from 70.9 μGy–63.7 μGy to 63.7 μGy–55.7 μGy (p < 0.0001). Conclusion The Baby Cone enhanced collimation as a crucial radiation protection strategy in mobile neonatal radiography that minimised entrance skin dose for chest and abdomen examinations. Implications for practice Implementing the Baby Cone may promote the adoption of improved collimation techniques in neonatal radiography, potentially shaping updated best practices in the field.