Medical imaging practice changed dramatically with the introduction of digital imaging. Although digital imaging has many advantages, it also has made it easier to delete images that are not of diagnostic quality. Mistakes in
imaging—from improper patient positioning, patient movement during the examination, and selecting
improper equipment—could go undetected when images are deleted. Such an approach would preclude a reject
analysis from which valuable lessons could be learned. In the analog days of radiography, saving the rejected
films and then analyzing them was common practice among radiographers. In principle, reject analysis can
be carried out easier and with better tools (ie, software) in the digital era, provided that rejected images are
stored for analysis. Reject analysis and the subsequent lessons learned could reduce the number of repeat
images, thus reducing imaging costs and decreasing patient exposure to radiation. The purpose of this study, which was conducted by order of the Dutch Healthcare Inspectorate, was to investigate whether hospitals in the Netherlands store and analyze failed imaging and, if so, to identify the tools used to analyze those images.