Assessment of Digital Radiography Implementation and Image Quality at Teaching Hospitals in Delta State, South South Nigeria

The transition from conventional film-based to digital radiography systems represents a major infrastructure transformation in Nigerian teaching hospitals, with direct implications for image quality, radiation dose efficiency, workflow productivity, and teleradiology capacity. In Delta State, where teaching hospitals have progressively adopted digital radiography, the quality of image output and the completeness of digital system implementation warrant systematic evaluation. This study assesses the implementation status of digital radiography and evaluates resulting image quality at teaching hospitals in Delta State. A cross-sectional audit design is applied to the radiology departments of Delta State University Teaching Hospital Oghara and Central Hospital Warri. Image quality assessment uses the European Commission criteria for radiographic image quality, applied to 240 digitally acquired radiographs across six anatomical regions. Implementation status is assessed through structured interviews with 55 radiographers on system utilisation, PACS connectivity, and workflow integration. Descriptive statistics and chi-square tests are computed in SPSS. Available digital radiology literature from South South Nigeria identifies image receptor parameter misconfiguration as a significant cause of noise-related image quality problems following transition from film-based systems. The IPEM Report 91 digital X-ray imaging guidelines and IAEA digital imaging quality reference provide the normative standards. Findings are expected to reveal good implementation progress alongside residual image quality optimisation needs, particularly in peripheral examination rooms. Recommendations address exposure index optimisation, PACS connectivity completion, and systematic image quality monitoring programmes at Delta State teaching hospitals. Keywords: digital radiography, image quality, Delta State, teaching hospitals, South South Nigeria.