PROPOSED NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR STANDARD RADIOGRAPHIC X-RAY PROCEDURES IN SUDAN

2020 ◽  
Vol 190 (4) ◽  
pp. 419-426
Author(s):  
Nada A Ahmed ◽  
E H Basheir ◽  
A B Farah ◽  
T S Mohammedzein ◽  
I I Suliman
Keyword(s):  
Lumbar Spine ◽  
Dose Optimization ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Air Kerma ◽  
Tube Output ◽  
The Mean ◽  
Entrance Surface Air Kerma

Abstract This study aimed to calculate patient radiation doses for adults during the seven most commonly performed conventional X-ray procedures, and to propose national diagnostic reference levels (DRLs). A representative sample of patients from 29 hospitals was included. The entrance surface air kerma (ESAK) was calculated by measuring X-ray tube output and the corresponding technical and exposure factors for each patient. Third-quartile values of the mean ESAK distributions were proposed as DRL values. The DRLs in mGy were as follows: 0.6 for chest postero–anterior (PA), 3.5 for skull AP, 1.7 for skull lateral (LAT), 2.7 for abdominal, 2.6 for pelvic AP, 3.7 for lumbar spine AP and 8 for lumbar spine LAT. Compared with literature, the maximum percentages increase were in chest PA (329%) and skull AP (187%). Since the suggested DRL for chest PA was higher than literature values, dose optimization and a review of its value is recommended.

ESTIMATION OF ENTRANCE SURFACE AIR KERMA IN DIGITAL RADIOGRAPHIC EXAMINATIONS

2021 ◽  
Vol 193 (1) ◽  
pp. 16-23
Author(s):  
Chanchal Kaushik ◽  
Inderjeet Singh Sandhu ◽  
A K Srivastava ◽  
Mansi Chitkara
Keyword(s):  
Cervical Spine ◽  
Lumbar Spine ◽  
Dose Assessment ◽  
Dose Calculations ◽  
Energy Agency ◽  
X Ray ◽  
Air Kerma ◽  
Tube Output ◽  
Effective Doses ◽  
Entrance Surface Air Kerma

Abstract Purpose: Contribution of radiation doses from medical X-ray examination to collective dose is significant. Unusually, high doses may increase the risk of stochastic effects of radiations. Therefore, radiation dose assessment was performed in 241 digital X-ray examinations in the study and was compared with published dose reference levels (DRLs). Methods: Entrance surface air kerma (ESAK) was calculated in chest PA, cervical AP/Lat, abdomen AP, lumbar AP/Lat and pelvis AP digital radiographic examinations (119 male and 122 female) following the International Atomic Energy Agency recommended protocol. Initially, 270 digital examinations were selected, reject analysis was performed and final 241 examinations were enrolled in the study for dose calculations. The exposure parameters and X-ray tube output were used for dose calculations. Effective doses were estimated with the help of conversion coefficients from ICRP 103. Results: Median ESAK (mGy) and associated effective doses obtained were cervical spine AP (1.30 mGy, 0.045 mSv), cervical spine Lat (0.25 mGy, 0.005 mSv), chest PA (0.11 mGy, 0.014 mSv), abdomen AP (0.90 mGy, 0.118 mSv), lumbar spine AP (1.52 mGy, 0.177 mSv), lumbar spine Lat (7.76 mGy, 0.209 mSv) and pelvis AP (0.82 mGy, 0.081 mSv). Results were compared with the studies of UK, Oman, India and Canada. Conclusion: The calculated ESAK and effective dose values were less than or close to previously published literature except for cervical spine AP and lumbar spine Lat. The results reinforce the need for radiation protection optimization, improving examination techniques and appropriate use of automatic exposure control in digital radiography. ESAK values reported in this study could further contribute to establishing local DRLs, regional DRLs and national DRLs.

scholarly journals Analysis of Average Glandular Dose (AGD) and Associated Parameters for Conventional and Digital X-Ray Mammography

2021 ◽  
Author(s):  
Ibrahim Idris Suliman ◽  
Sawsan Mohamed ◽  
Alaa Mahadi ◽  
Einas Bashier ◽  
A Farah ◽  
...  
Keyword(s):  
Patient Specific ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Air Kerma ◽  
Essential Step ◽  
Patient Protection ◽  
Average Glandular Dose ◽  
Tube Output ◽  
Conversion Coefficients

Abstract In this study, we determined the average glandular dose (AGD) from the craniocaudal (CC) and mediolateral oblique (MLO) views of 496 breasts (247 women) at eight clinics in Sudan. The incident air kerma from the X-ray tube output values and typical patient-specific breast exposure factors were measured. AGD values were inferred from the measured incident air kerma and breast-specific dose conversion coefficients. The AGD per CC and MLO projection and per woman ranged from 0.34–5.3 mGy (average: 2.46), 0.29–3.39 mGy (average: 1.50), and 0.6–7.4 mGy (average: 3.95). The proposed national diagnostic reference levels (mGy) are 3.48, 2.03, and 6.44 mGy for CC, MLO, and per woman, respectively. Establishing the proposed diagnostic reference levels is an essential step in ensuring patient protection from radiation and will help promote dose optimization for X-ray mammography at the national levels and beyond. The results provide important baseline data that can be used to formulate the national diagnostic reference levels.

scholarly journals Establishment of local diagnostic reference levels for typical radiography examinations in the west region of Croatia

2019 ◽  
Vol 34 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Doris Segota ◽  
Ana Diklic ◽  
Slaven Jurkovic
Keyword(s):  
Public Health ◽  
University Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
West Region ◽  
Public Health Institutions ◽  
Patient Doses ◽  
Health Institutions ◽  
Entrance Surface Air Kerma

Majority of health institutions in Croatia do not have medical physicists in diagnostic radiology. Regarding this, in the west region of Croatia collaboration between public health institution and University Hospital Rijeka was initiated in 2015. Quality Assurance program was implemented in these public health institutions during 2015 and 2016 and the next step was to assess patient doses for the most frequent X-ray examinations. This included five public health institutions: 1 university hospital, 1 general hospital, 1 special hospital, 2 public health institutions with 13 facilities. The aim of this study was to carry out assessment of patient doses and to establish local diagnostic reference levels of entrance surface air kerma for every institution for six most frequent X-ray examinations. Also, local diagnostic reference levels for the whole west region of Croatia were established and compared with the national diagnostic reference levels and latest published data. Median entrance surface air kerma values for thorax PA, thorax LAT, cervical spine AP, thoracic spine AP, lumbar spine AP, pelvis AP and sinuses are 0.14 mGy, 0.50 mGy, 0.52 mGy, 1.50 mGy, 2.52 mGy, 2.03 mGy, and 1.03 mGy, respectively. Diagnostic reference levels proposed for our region were comparable with other studies.

PROPOSAL FOR LOCAL DIAGNOSTIC REFERENCE LEVELS IN GENERAL RADIOGRAPHY IN JAPAN

2019 ◽  
Author(s):  
Yasuki Asada ◽  
Koji Ono ◽  
Yuya Kondo ◽  
Kazuma Sugita ◽  
Takuma Ichikawa ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Distributions ◽  
X Ray ◽  
Non Invasive ◽  
Air Kerma ◽  
Aichi Prefecture

Abstract The present study aimed to propose local diagnostic reference levels (DRLs) formulated by calculating entrance surface doses for general radiography at 20 facilities of Aichi prefecture in Japan, by comparing these values with DRLs established in Japan in 2015 (DRLs 2015) and assessing radiation dose differences among facilities. X-ray outputs (half-value layer and air kerma) of each facility were measured with a non-invasive type of detector. The results were employed to formulate local DRLs based on the 75th percentiles of dose distributions. These local DRLs were lower than the DRLs 2015 for all examinations. If proposed local DRLs from other 46 prefectures can be collected, this paper can be used to benefit the next effort to draft better DRL for Japan.

scholarly journals Patient dose measurement in common medical X-ray examinations and propose the first local dose reference levels to diagnostic radiology in Iran

2017 ◽  
Vol 23 (3) ◽  
pp. 67-71
Author(s):  
Behrouz Rasuli ◽  
Raheleh Tabari Juybari ◽  
Meysam Forouzi ◽  
Mohammad Ghorbani
Keyword(s):  
Patient Dose ◽  
Skin Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Anatomical Data ◽  
Patient Load ◽  
Tube Output ◽  
Patient Doses ◽  
Southwest Of Iran

Abstract Introduction: The main purpose of this study was to investigate patient dose in pelvic and abdomen x-ray examinations. This work also provided the LDRLs (local diagnostic reference levels) in Khuzestan region, southwest of Iran to help establish the NDRLs (national diagnostic reference levels). Methods: Patient doses were assessed from patient’s anatomical data and exposure parameters based on the IAEA indirect dosimetry method. With regard to this method, exposure parameters such as tube output, kVp, mAs, FFD and patient anatomical data were used for calculating ESD (entrance skin dose) of patients. This study was conducted on 250 standard patients (50% men and 50% women) at eight high-patient-load imaging centers. Results: The results indicate that mean ESDs for the both pelvic and abdomen examinations were lower than the IAEA and EC reference levels, 2.3 and 3.7 mGy, respectively. Mean applied kVps were 67 and 70 and mean FFDs were 103 and 109, respectively. Tube loadings obtained in this study for pelvic examination were lower than all the corresponding values in the reviewed literature. Likewise, the average annual patient load across all hospitals were more than 37000 patients, i.e. more than 100 patients a day. Conclusions: The authors recommend that DRLs (diagnostic reference levels) obtained in this region, which are the first available data, can be used as local DRLs for pelvic and abdomen procedures. This work also provides that on-the-job training programs for staffs and close cross collaboration between physicists and physicians should be strongly considered.

scholarly journals Radijaciono opterecenje pacijenata u konvencionalnoj dijagnostickoj radiologiji - analiza radioloske prakse u Srbiji

2007 ◽  
Vol 54 (3) ◽  
pp. 93-98
Author(s):  
O.F. Ciraj-Bjelac ◽  
M.S. Kovacevic ◽  
D.D. Kosutic ◽  
S.S. Stankovic
Keyword(s):  
Total Population ◽  
X Rays ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Patient Doses ◽  
Area Product ◽  
First Time ◽  
Dose Variation ◽  
Entrance Surface Air Kerma

X-rays are by far most significant contributor to total population dose from man-made sources of radiation. Diagnostic reference levels provide frameworks to reduce variability. The aim of this study is to establish, for the first time, a baseline for national diagnostic reference levels in Serbia for the most common X-ray examination types. Dose estimates are based on measurements of kerma-area product and Entrance surface air kerma for at least ten patients for each examination type, in each of 16 randomly selected hospitals in Serbia. Mean, median and third quartile values of patient doses are reported. Results have shown wide variation of mean hospital doses. Entrance surface doses were compared with previously published diagnostic reference levels. Doses for all studied examination types except chest radiography were within European DRL. The reasons for dose variation are discussed. The findings emphasize the importance of regular patient dose measurement to ensure that patient doses are kept as low as reasonable achievable.

scholarly journals Evaluation of Patient Radiation Doses in Skull Radiography

2019 ◽  
Vol 5 (2) ◽  
pp. 51-56
Author(s):  
Chanchal Kaushik ◽  
Inderjeet Singh Sandhu ◽  
AK Srivastava
Keyword(s):  
Diagnostic Information ◽  
Radiation Doses ◽  
Reference Levels ◽  
Energy Agency ◽  
Stochastic Effects ◽  
Air Kerma ◽  
Skull Radiography ◽  
Effective Doses ◽  
Ionizing Radiations ◽  
Entrance Surface Air Kerma

Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information. Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA). Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.Conclusion: The comparison revealed that the calculated ESAK and effective dose values wereless than the published literature. ESAK values reported in this study could further contribute toestablishing LDRLs.

PATIENT DOSES IN COMMON DIAGNOSTIC X-RAY EXAMINATIONS

2018 ◽  
Vol 184 (1) ◽  
pp. 12-27 ◽  
Author(s):  
Vasileios I Metaxas ◽  
Gerasimos A Messaris ◽  
Aristea N Lekatou ◽  
Theodore G Petsas ◽  
George S Panayiotakis
Keyword(s):  
Cervical Spine ◽  
Lumbar Spine ◽  
Radiation Dose ◽  
Urinary Bladder ◽  
European Level ◽  
Reference Levels ◽  
Technical Data ◽  
X Ray ◽  
National Reference ◽  
The Mean

Abstract A local survey was conducted, to evaluate the radiation dose to adult patients who underwent diagnostic X-ray examinations. Patient-related and technical data were recorded, in 1504 patients, for each of the 11 individual projections, of the 7 most common examinations performed in an X-ray room, with 1 digital radiography system. The patient entrance surface air kerma (ESAK) and the effective dose (ED) were calculated based on the X-ray tube output and the exposure parameters, as well as utilisation of suitable conversion coefficients, respectively. The 75th percentiles of the distribution of the ESAK and kerma area product (KAP) values were also established. The mean, median and 75th percentiles were compared with the national reference levels and the most common values reported at the European level through the DOSE DATAMED II project. The corresponding ED values were also compared with the average values reported for all European countries. The mean ESAK, KAP and ED values along with the uncertainty U values for chest PA, chest LAT, cranium AP, cranium LAT, cervical spine AP, cervical spine LAT, lumbar spine AP, lumbar spine LAT, pelvis AP, abdomen AP, kidneys and urinary bladder (KUB) AP were 0.12 (0.001) mGy, 0.66 (0.023) mGy, 1.01 (0.034) mGy, 0.69 (0.098) mGy, 0.72 (0.014) mGy, 0.63 (0.011) mGy, 4.12 (0.050) mGy, 5.74 (0.082) mGy, 2.57 (0.024) mGy, 1.94 (0.017) mGy, 2.47 (0.073) mGy, and 0.09 (0.001) Gy cm2, 0.38 (0.012) Gy cm2, 0.32 (0.009) Gy cm2, 0.27 (0.052) Gy cm2, 0.17 (0.004) Gy cm2, 0.21 (0.006) Gy cm2, 1.18 (0.018) Gy cm2, 1.86 (0.023) Gy cm2, 1.41 (0.012) Gy cm2, 1.27 (0.010) Gy cm2, 1.28 (0.038) Gy cm2, as well as 0.01 (0.0001) mSv, 0.05 (0.0016) mSv, 0.02 (0.0006) mSv, 0.01 (0.0012) mSv, 0.03 (0.0008) mSv, 0.03 (0.0006) mSv, 0.26 (0.0038) mSv, 0.17 (0.0022) mSv, 0.20 (0.0016) mSv, 0.23 (0.0018) mSv, 0.23 (0.0068) mSv, respectively. The 75th percentiles along with the uncertainty U values for chest PA, chest LAT, cranium AP, cranium LAT, cervical spine AP, cervical spine LAT, lumbar spine AP, lumbar spine LAT, pelvis AP, abdomen AP, kidneys and urinary bladder (KUB) AP were 0.14 (0.006) mGy, 0.88 (0.031) mGy, 1.22 (0.049) mGy, 0.94 (0.098) mGy, 0.93 (0.027) mGy, 0.78 (0.013) mGy, 5.16 (0.073) mGy, 7.24 (0.134) mGy, 2.96 (0.047) mGy, 2.59 (0.036) mGy, 3.07 (0.116) mGy, as well as 0.10 (0.0006) Gy cm2, 0.51 (0.017) Gy cm2, 0.37 (0.020) Gy cm2, 0.33 (0.040) Gy cm2, 0.23 (0.007) Gy cm2, 0.26 (0.011) Gy cm2, 1.50 (0.036) Gy cm2, 2.26 (0.035) Gy cm2, 1.61 (0.023) Gy cm2, 1.67 (0.017) Gy cm2, 1.56 (0.069) Gy cm2, in terms of ESAK and KAP values, respectively. The results were significantly lower compared with the national reference levels, the most common DRL values reported at the European level and other previously reported dose values. Patient dose surveys could contribute towards optimising radiation protection for patients, therefore, highlighting the necessity to increase the awareness and knowledge of the radiation dose in conjunction with the required image quality.

scholarly journals Comparison of entrance surface air kerma measurement with MTS-N (LiF: Mg, Ti) chips with a kilovoltage X-ray source

2021 ◽  
Vol 22 (1) ◽  
pp. 20-34
Author(s):  
Akintayo Daniel Omojola ◽  
Samuel Olaolu Adeneye ◽  
Michael Onoriode Akpochafor ◽  
Isiaka Olusola Akala ◽  
Azuka Anthonio Agboje
Keyword(s):  
Ionization Chamber ◽  
Radiation Detectors ◽  
Field Size ◽  
Peak Voltage ◽  
X Ray ◽  
Air Kerma ◽  
Image Distance ◽  
The Mean ◽  
Dose Accuracy ◽  
Entrance Surface Air Kerma

Objective: Radiation detectors are key components that ensure the accuracy and performances of dosimetry equipment. The study is aimed to compare the mean entrance surface air kerma (ESAK) between a DCT-10mm ionization chamber (IC) and MTS-N (LiF: Mg, Ti) chips when both detectors are exposed to ≤ 5mGy with a 10 by 10 field size, with an X-ray source and to determine the accuracy of the Thermoluminescent (TL) chips. Also, the dose will be compared to similar studies. Materials and Methods: A functional, Digital Radiography (DR) X-ray System was used. A DCT-10mm ionization chamber (IC) and an XR Multidetector was positioned at a Source to Image Distance (SID) of 100cm on polystyrene, about 20cm thick. An X-ray spectrum generated at a Practical Peak Voltage (PPV) of 60-107kV with Half Value Layer (HVL) of 2.4-4.3mmAl and filtration > 3mmAl was used. The same setup was used for the MTS-N chips. Results: The mean doses for 1-5 mGy with the MTS-N chips were 1.07±0.07, 1.60±0.13, 2.23±0.11, 2.58±0.07 and 3.45±0.10 mGy respectively, with accuracies of 7, 20, 26, 36 and 31%. Dose accuracy at 1and 2mGy was within 25% respectively. Dose accuracies at 3, 4 and 5mGy was within >25%. The correction factor for 1-5mGy was 0.94, 1.25, 1.35, 1.55 and 1.45 respectively. Conclusion: Validation of the MTS-N chips with the reference ionization chamber to this study was within 36%. The Radiation and Nuclear Safety Authority (STUK) recommends that ESAK be within 25% for entrance surface dose. ESAK accuracy mostly increased with dose as observed in this study.

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