Effect of Obesity on Image Quality: Fifteen-year Longitudinal Study for Evaluation of Dictated Radiology Reports

Purpose: To retrospectively assess the effect of obesity on image quality, as determined from dictated radiology reports filed between 1989 and 2003.

Materials and Methods: Institutional review board approval was obtained for this HIPAA-compliant study; informed consent was not required. Electronic records were searched for radiology reports with the phrase “limited due to body habitus” (hereafter, “habitus limited”) filed between 1989 and 2003; reports were retrospectively reviewed. Habitus limited was qualified as the search phrase by auditing radiologic images and patient weights. Trends in the number of habitus-limited reports were calculated for each year, and linear regression analysis was performed. The number of habitus-limited reports was also compared between modalities within a year and within each modality across 15 years. The trend was correlated with the prevalence of obesity in Massachusetts by using the Pearson correlation coefficient.

Results: There was a significant difference (P < .001) between the weight of patients with habitus-limited reports and the weight of patients with reports that were not habitus limited. Overall, 7778 (0.15%) of 5 253 014 reports were habitus limited. Between 1989 and 2003, there was a linear increase of 0.010% per year (95% confidence interval: 0.007%, 0.013%; P < .001). There was a positive correlation between the increased number of habitus-limited reports and the increased prevalence of obese individuals in Massachusetts between 1991 and 2001. The modality most commonly associated with habitus-limited reports was abdominal ultrasonography.

Conclusion: There was a small but progressive increase in the number of habitus-limited radiology reports between 1989 and 2003.

© RSNA, 2006


  • 1 Centers for Disease Control and Prevention. Overweight and obesity: obesity trends—1991–2001. Prevalence of obesity among U.S. adults by state. Department of Health and Human Services Web site. http://www.cdc.gov/nccdphp/dnpa/obesity/trend/prev_reg.htm. Accessed May 22, 2006.
  • 2 Rundle RL. U.S.'s obesity woes put a strain on hospitals in unexpected ways. Wall Street Journal Online Edition. May 1, 2002. online.wsj.com/article/0,,SB1020194636122710680.djm,00.html. Accessed July 1, 2005.
  • 3 Wittmer MH, Duszak R, Lewis ER, Wagner BJ. Does obesity degrade image quality of helical CT for suspected pulmonary embolism? [abstr]. AJR Am J Roentgenol 2004; 182(4): 113.
  • 4 Elmore JG, Carney PA, Abraham LA, et al. The association between obesity and screening mammography accuracy. Arch Intern Med 2004;164(10):1140–1147.
  • 5 Halpern BS, Dahlbom M, Quon A, et al. Impact of patient weight and emission scan duration on PET/CT image quality and lesion detectability. J Nucl Med 2004;45(5):797–801.
  • 6 Kumar S, Moro L, Narayan Y. Perceived physical stress at work and musculoskeletal discomfort in x-ray technologists. Ergonomics 2004;47(2):189–201.

Article History

Published in print: Aug 2006