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 Optimisation of pelvic imaging radiography protocols in plain radiology: a scoping review

2021 ◽  
Vol 12 (1) ◽  
pp. 3-11
Author(s):  
Alenka Matjašič ◽  
Nejc Mekiš
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
Scoping Review ◽  
Diagnostic Value ◽  
Optimization Techniques ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Starting Point ◽  
Ebsco Host

Introduction: The purpose of this work is to explore which studies have been performed in the field of radiation dose reduction in pelvic x-ray imaging and to determine optimization techniques for dose reduction.Materials and methods: A scoping review was performed by using databases Science Direct, PubMed, EBSCO Host and Springer Link. The keywords used were "radiography", "dose reduction", "pelvis" and "pelvic". Exclusion criteria were the keywords "CT" and "MRI".Results: 15 scientific articles that analyse the current dose impacts in selected institutions or regions were reviewed as a starting point to optimise protocols, to establish diagnostic reference levels, or to suggest different measures for dose reduction. Studies suggest the use of digital image receptor, adaptation of exposure parameters; they also point out the use of air gap instead of radiographic grid and investigate the usefulness of the gonad protection. A difference was noticed in developing countries that focus more on the establishment of DRLs and following the guidelines provided by other countries rather than developing new dose optimisation techniques.Conclusion: A pelvic x-ray must be performed with a low radiation dose impact that still doesn't compromise the diagnostic value of the image, which can be achieved by following the ALARA principle and with certain adjustments, suggested by the considered studies, especially with exposure parameters. The establishment of national and local diagnostic reference levels is also required.

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.

LOW BMI PATIENT DOSE IN DIGITAL RADIOGRAPHY

2020 ◽  
Vol 189 (1) ◽  
pp. 1-12
Author(s):  
Fotios O Efthymiou ◽  
Vasileios I Metaxas ◽  
Christos P Dimitroukas ◽  
George S Panayiotakis
Keyword(s):  
Lumbar Spine ◽  
Radiation Dose ◽  
Digital Radiography ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Significant Difference ◽  
Low Bmi

Abstract In this study, the radiation dose received by 364 low body mass index (BMI) adult patients undergoing chest, abdomen, lumbar spine, kidneys and urinary bladder (KUB) and pelvis X-ray examinations in an X-ray room with a digital radiography system was evaluated. The patients’ kerma area product (KAP) values were recorded, and the entrance surface air kerma (ESAK) was calculated based on the X-ray tube output, exposure parameters and technical data. The 75th percentiles of the distribution of ESAK and KAP values were also estimated. The dose values were compared with the corresponding values for normal patients obtained from a previous survey in our hospital, as well as with the national and UK diagnostic reference levels (DRLs). The correlation of dose values with patient size metrics (mass, height, BMI) was also investigated. A statistically significant difference was found in KAP and the ESAK values between low BMI and normal patients (Mann–Whitney test, p < 0.05), for all examinations studied. The percentage difference for chest PA, chest LAT, abdomen PA, lumbar spine AP, lumbar spine LAT, pelvis AP and KUB AP examinations was 40, 36, 48, 68, 57, 46 and 67% for median KAP and 26, 43, 52, 48, 19, 44 and 51% for median ESAK, respectively. The corresponding 75th percentiles for low BMI patients were 0.065, 0.349, 0.683, 1.54, 3.92, 1.11, 0.67 mGy and 0.042, 0.218, 0.450, 0.280, 0.598, 0.597, 0.267 Gycm2 in terms of ESAK and KAP values, respectively. They were 74–90% lower compared to the national diagnostic reference levels (DRLs), 35–84% and 58–82% compared to the UK DRLs, for ESAK and KAP values, respectively. Regarding the gender of the patients, no statistically significant difference was found in the dose values between female and male patients (Mann–Whitney test, p > 0.05), for all examinations studied. A statistically significant correlation was found between ESAK and KAP values with BMI for KUB AP, pelvis AP, lumbar spine AP, lumbar spine LAT and chest PA, while for chest LAT examinations, only the ESAK were significantly correlated with BMI. They also significantly correlated with the mass for KUB AP, lumbar spine LAT, abdomen PA and chest PA examinations, while no significant correlation was found between the dose values and patients’ height. It can be concluded that the low BMI patients received a significantly reduced radiation dose compared to normal patients. Additional studies need to be conducted for these patient groups, which could contribute to the further development of a radiation protection culture in diagnostic radiography.

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.

Diagnostic Reference Levels for Common Orthopedic Hand and Wrist Procedures Using Intraoperative mini C-arm Fluoroscopy

Hand ◽  
2021 ◽  
pp. 155894472199425
Author(s):  
Kiran R. Madhvani ◽  
Matthew J. R. Clark ◽  
Alex A. J. Kocheta
Keyword(s):  
Radiation Dose ◽  
Fracture Fixation ◽  
Wrist Fracture ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Audit Data ◽  
Small Joint ◽  
Open Fixation ◽  
Phalangeal Fracture

Background: Diagnostic reference levels are radiation dose levels in medical radiodiagnostic practices for typical examinations for groups of standard-sized individuals for broadly defined types of equipment. This study aimed to contribute to national diagnostic reference levels for common hand and wrist procedures using mini C-arm fluoroscopy. Small joint and digital fracture procedure diagnostic reference levels have not been reported in significant numbers previously with procedure-level stratification. Methods: Data were collected from fluoroscopy logbooks and were cross-referenced against the audit log kept on fluoroscopy machines. A total of 603 procedures were included. Results: The median radiation dose for wrist fracture open fixation was 2.73 cGycm2, Kirschner wiring (K-wiring) procedures was 2.36 cGycm2, small joint arthrodesis was 1.20 cGycm2, small joint injections was 0.58 cGycm2, and phalangeal fracture fixation was 1.05 cGycm2. Conclusions: Wrist fracture fixation used higher radiation doses than phalangeal fracture fixation, arthrodeses, and injections. Injections used significantly less radiation than the other procedures. There are significant differences in total radiation doses when comparing these procedures in hand and wrist surgery. National and international recommendations are that institutional audit data should be collected regularly and should be stratified by procedure type. This study helps to define standards for this activity by adding to the data available for wrist fracture diagnostic reference levels and defining standards for digital and injection procedures.

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

Sign in / Sign up

Export Citation Format

Share Document