What is a Chest X-ray (Chest X-ray : CXR)?
A chest X-ray, or Chest X-ray : CXR, is an examination of the chest area using X-ray radiation to screen and detect lesions in various organs of the respiratory system, especially lung-related diseases. A chest X-ray can detect spots or masses in the lung tissue, abnormalities of the pleura, and blood vessels in the lungs, as well as nearby organs located in the chest area.
The X-ray image appears on the film in black, gray, and white colors. The intensity of the colors indicates the structural characteristics of different organs. For example, black represents areas of tissue containing air, which are parts of the lungs, while white indicates high density of calcium, which is part of the bone structure, and so on.
Who should get a Chest X-ray (Chest X-ray : CXR)?
Those who should undergo a chest X-ray (CXR) are individuals at risk of various lung diseases, including lung cancer, as follows:
- Those experiencing shortness of breath, difficulty breathing, easy fatigue, or chest pain
- Those infected with COVID-19 and having lung symptoms
- Those with asthma, pneumonia, or tuberculosis
- Those with respiratory system problems caused by infections or exposure to air pollution, including PM2.5 dust
- Heavy smokers for more than 10 years, those with family members who smoke, or those regularly exposed to secondhand smoke
- Individuals aged 50 and above with a history of smoking, even if they have quit
- Those who work or live in environments with prolonged exposure to pollutants and toxins, such as asbestos, chromium, radon, nickel, radioactive gases (radon), or pollution from engine combustion like car exhaust or factory smoke
- Those with a history of lung disease or family members with lung cancer
Chest X-ray Procedure (Chest X-ray : CXR)
Patients wear clothing provided by the hospital. Women must remove their bras and tie their hair up away from the neck area. When ready, the staff will help position the patient standing in front of the X-ray machine. Then, the staff will signal or instruct the patient to take a deep breath and hold it. The staff will then expose the chest to X-ray radiation to capture the image, which takes only 1-2 seconds. After this step, the patient changes back into their clothes and waits for the results from the ordering physician, who will provide the X-ray images and related information within minutes after the examination.
Preparation before Chest X-ray (Chest X-ray : CXR)
- No special preparation is required
- No need to fast or stop taking food, water, or medication
- Do not wear jewelry or clothing containing metal, especially around the chest area
- If the patient has had surgery and has metal implants or parts in the body, inform the doctor beforehand
- If pregnant or suspect pregnancy, inform the doctor beforehand because X-rays can affect the fetus
- For patients with chronic obstructive pulmonary disease (COPD), holding breath may be difficult, so inform the doctor before the X-ray
Interpretation and Evaluation of Chest X-ray (Chest X-ray : CXR)
Besides interpreting the chest X-ray images, doctors may use patient history, laboratory test results, or other pathological examinations as additional information for diagnosis, such as chronic cough, coughing up blood, internal chest injuries, and abnormal breathing symptoms.
The chest X-ray results can reveal abnormalities in shape, spots or masses in the lungs, blood vessels in the lungs, tissues surrounding various organs in the chest area, rib and clavicle bone structures, as well as the size of the heart and diaphragm. This helps doctors accurately diagnose diseases such as pneumonia, lung infection, lung cancer, and other diseases of the chest organs.
If spots or masses are detected on the lung film, those smaller than 5 millimeters have a relatively low risk of being cancerous cells. However, if larger than 10 millimeters, the likelihood of the mass being cancerous is higher.
After detecting abnormalities, doctors will consider additional tests or schedule a repeat chest X-ray within 3-6 months to closely monitor the growth of the mass. If the mass grows abnormally fast, further tests are needed for a clear diagnosis and immediate treatment. Early detection of cancer when it is still a small mass increases the chance of complete cure.
Additionally, chest X-rays may be performed for pre-surgical preparation, post-surgical follow-up, pre-employment screening, or for international travel purposes.