Measurement of Entrance Skin Dose in Radiographic Examinations of Pediatric Patients

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210628162238 ◽

2021 ◽

Vol 17 ◽

Author(s):

Yousif Abdallah

Keyword(s):

Saudi Arabia ◽

Radiation Dose ◽

Pediatric Patients ◽

Skin Dose ◽

Trauma Patients ◽

Surface Dose ◽

X Ray ◽

Entrance Surface Dose ◽

Entrance Skin Dose ◽

The Mean

Background: To measure the entrance skin dose in radiographic examinations of pediatric patients in King Khalid Hospital, Majmaah, Saudi Arabia Introduction: Children have been given special attention since they are often regarded as especially vulnerable to potential hazards. The pediatric population is more susceptible to radiation than the adult population for certain tumor types. Objective: The aim of this study is to determine the amount of Entrance Surface Dose (ESD) received by pediatric patients attending the emergency department. Method: Traumatic department registers for pediatric patients attending the King Khalid hospital (Majmaah, Saudi Arabia) between 1st February and 31st December 2018 were retrospectively studied for all diagnostic (plain radiographs examinations) imaging did on pediatric (<18 years old) trauma patients. The entrance surface dose was used to calculate the total radiation dose for each patient. One hundred and twenty patients encountered the inclusion criteria of the study, and their doses (chest, skull, and extremities) were assessed. Results: The mean of radiation exposure factors were 65.4 ± 7.9 (71.3 – 89.9) and 1.3 ± 0.2 (0.3–2.5) for X-ray tube potential (kVp) and current (mAs), respectively. The measured dose for pediatric patients were 0.10 ± 0.02 (0.09 – 0.37), 0.18 + 0.04 (0.06 -0.59) and 0.09 + 0.03 (0.03 -0.45) for chest, skull, and extremities, respectively. The mean Entrance surface dose received by trauma patients was 0.03-0.59 mGy. 51.7% (62 patients) of the patients received ≤ 0.25 mGy while around 48.3% (58 patients) received ≥ 0.26 mGy radiation dose from those examinations. Conclusion: Trauma patients attending to traumatic radiology department obtain substantial Entrance surface dose from chest, skull, and extremities imaging procedures within their initial assessment. The radiation exposure can also be lowered by optimizing each examination. Therefore more studies are recommended for this task. The results obtained can be used as the basis for local reference dosages for X-ray examinations.

Download Full-text

Regional survey of entrance surface dose to patients from X-ray examinations in Saudi Arabia

Australasian Physical & Engineering Sciences in Medicine ◽

10.1007/s13246-015-0340-y ◽

2015 ◽

Vol 38 (2) ◽

pp. 299-303 ◽

Cited By ~ 2

Author(s):

M. K. Saeed

Keyword(s):

Saudi Arabia ◽

Surface Dose ◽

Regional Survey ◽

X Ray ◽

Entrance Surface Dose

Download Full-text

Entrance Skin Dose (Radiation) Measurement and Evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Nigeria

Open Science Journal ◽

10.23954/osj.v3i2.1658 ◽

2018 ◽

Vol 3 (2) ◽

Author(s):

Abiola Olawale Ilori ◽

Gilbert Ibitola ◽

Olanrewaju Ajanaku ◽

Reuben Dapo Utomewore

Keyword(s):

Health Workers ◽

Radiation Risk ◽

Age Groups ◽

The State ◽

Skin Dose ◽

Radiation Measurement ◽

X Ray ◽

Entrance Skin Dose ◽

The Mean ◽

Measurement And Evaluation

This study was carried out on entrance skin dose (ESD) (Radiation) measurement and evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Ondo State, Nigeria. Entrance skin doses for randomly selected patients between 0-4 years, 5-9 years, 10-17 years and above 18 years old undergoing X-ray chest (Poster Anterior) examinations were measured and evaluation of the source-to-skin distance (SSD) records for the patients during the x-ray chest examinations were carried out. The mean ESD reported for chest PA projections were 66.43 µGy, 105.10 µGy, 215.76 µGy and 291.81 µGy respectively for age range 0 - 4 years, 5 - 9 years, 10 - 17 years and above 18 years. The ESD values reported in this present study were same with the NRPB recommendations of year 2000 of 50 µGy for newborn to 1-year-old, 70 µGy for 5 years and 120 µGy for 10 years old children. The values reported for age 1 to 4 years were lower than 0.1 mGy recommended and the mean ESD for age 5 to 9 years for chest PA examination was 0.11 mGy which is lower than the recommended 0.12 mGy. However, other values reported in this present study were compared with the guidance levels set by the International regulation bodies and were found to be within safe limits and they do not pose any significant health risk to the patients of all age ranges or the health workers. The effective radiation doses (ERDs) for all the age groups were computed, and by comparisons, it was found that the radiation risk factors (RRFs) are relatively low.

Download Full-text

Assessment of radiation dose to pediatric patients during routine digital chest X-ray procedure in a government medical centre in Asaba, Nigeria

Medical Science and Discovery ◽

10.36472/msd.v8i3.493 ◽

2021 ◽

Vol 8 (3) ◽

pp. 155-160

Author(s):

Asogwa Chijioke Obiora ◽

Hyacienth Uche Chiegwu ◽

Akintayo Daniel Omojola ◽

Ebube Mmeli Onwughalu

Keyword(s):

Radiation Dose ◽

Effective Dose ◽

Pediatric Patients ◽

Age Groups ◽

Absorbed Dose ◽

Field Size ◽

X Ray ◽

Chest X Ray ◽

The Mean ◽

Risk Of Cancer

Objective: Radiation dose to pediatric patients have been widely reported, it is however necessary that imaging expert keep doses as low as possible to forestall stall long term cancer risk. This study is aimed at determining pediatric entrance surface dose (ESD), 75th percentile ESD, absorbed dose (D) and effective dose (E) for 0-15 years. Material and Methods: The study used a digital radiography (DR) unit with a grid system for each chest X-ray. The thermoluminescent dosimeter (TLD) used was encapsulated in transparent nylon, it was then attached to the patient skin (chest wall) and the second was placed directly at the posterior end of it. Results: The mean ESDs for the 4 age groups were as follows: 0- < 1 (1.54±0.74mGy), 1- < 5 (1.53±0.83mGy), 5- < 10 (0.55±0.39mGy) and 10- ≤15 (1.30±0.57mGy), with an overall mean of 1.23mGy. The 75th percentile ESD for each age group above 10 patients (excluding 5- < 10yrs) was 2.18, 2.19 and 1.75mGy respectively. The absorbed dose (D) ranged from 0.03-2.39mGy. The mean effective dose (E) for the 4 age groups was 0.18±0.03mSv. There was a good correlation between ESD and D (P = 0.001). A One-Way ANOVA shows that the field size and focus to film distance (FFD) affected the ESD and D (P < 0.001) respectively. The risk of childhood cancer from a single radiograph was of the order of (1.54-23.4) ×10-6. Conclusion: The 75th percentile ESD, E and childhood risk of cancer was higher than most studies it was compared with. The study reveals that machine parameters such as the field size and FFD played a major role in dose increase. Protocol optimization is currently needed for pediatric patients in the studied facility.

Download Full-text

Determination of Entrance Surface Dose of Digital Radiography for Adults at Public Medical Imaging Centers, Erbil

Tabari Biomedical Student Research Journal ◽

10.18502/tbsrj.v3i2.6671 ◽

2021 ◽

Author(s):

Ilham Khalid Ibrahim

Keyword(s):

Absorbed Dose ◽

Public Hospitals ◽

Adult Patients ◽

Skin Dose ◽

Surface Dose ◽

Entrance Surface Dose ◽

Entrance Skin Dose ◽

Total Filtration ◽

Ionizing Radiations

Introduction: Diagnostic X-ray is one of the ionizing radiations, the level of radiation dose received by the patient during medical examination is essential to prevent cancer risks. The aim of this study is to calculate entrance surface dose (ESD) and effective dose (ED) were estimated during chest, and lumber spine for adult patients in three hospitals in Erbil, using NOMEX MULTIMETER and PCXMC software. Material and Methods: The study was conducted in three public hospitals, in Erbil on (250) adult patients, whose ages between (18-70) years, based on the results study, ESD and ED were calculated for chest (PA, lateral), and lumbar spine (AP, lateral) examinations. NOMEX MULTIMETER (PTW, Freiburg), used in measurement of tube voltage, dose, dose rate, time product current, and total filtration automatically during examination. ED was calculated by using PCXMC software (version 2.5). Results: The results of this work are compared with published international literatures. The mean entrance skin dose for examinations of chest (PA, Lat), and lumber spine (AP, Lat) 1.02, 1.06, 2.61 and 3.92 mGy respectively. ED value was from 0.08, 0.19, 0.32, and 0.33 mSv, for chest (PA, Lat), and lumber spine (AP, Lat), respectively. Conclusion: The ESD, and ED were calculated in this work were found to be agreement with the published reference values for chest, and lumber spine set by international levels. ALARA principle should be considered by radiographer, to reduce absorbed dose of adults’ patient undergoing imaging radiography.

Download Full-text

Radiation Dose and Image Quality in Neuroangiography: Effects of Increased Tube Voltage, Added X-Ray Filtration and Antiscatter Grid Removal

Interventional Neuroradiology ◽

10.1177/159101999800400304 ◽

1998 ◽

Vol 4 (3) ◽

pp. 199-207 ◽

Cited By ~ 9

Author(s):

M. Söderman ◽

B. Hansson ◽

B. Axelsson

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Image Intensifier ◽

Skin Dose ◽

Tube Voltage ◽

X Ray ◽

Gap Technique ◽

Entrance Skin Dose ◽

Patient Studies ◽

Antiscatter Grid

During endovascular treatment the patient may be subject to fluoroscopy for long periods as well as multiple x-ray exposures. The radiation dose to the patient can be considerable, and cause local deterministic effects such as alopecia or even skin burn. The potential carcinogenic effects should also be noted, being especially important in the paediatric population. We measured radiation doses to patients and personnel during neuroendovascular procedures and diagnostic neuroangiography. We also tried to reduce the radiation dose to the patient utilising increased tube voltage, additional primary X-ray filtration and by removing the antiscatter grid in front of the image intensifier, employing air gap technique. We investigated radiation doses to patient and personnel during neuroangiographic procedures and optimized the examination technique with regard to radiation dose with maintained image quality. Radiation exposure to patients and personnel was measured with thermoluminescent dosimeters and permanently mounted KermaDose-Area-Product meters in front of the X-ray tubes during 13 cerebral angiographies and six neuroendovascular procedures. We performed experiments with radiation dose measurements and evaluation of image quality with 80 and 90 kV tube voltage during image acquisition and 75 and 85 kV during fluoroscopy, as well as with different primary X-ray filtration. Images from patient studies acquired with the original grid in front of the image intensifier were compared with images from patient studies acquired with the grid removed and air gap technique (30 cm). Images from patient studies acquired with the original examination technique were compared to images from patient studies acquired with increased x-ray tube voltage, increased x-ray filtering and with the antiscatter grid removed using an airgap as scatter reduction method. Radiation exposure to personnel was very low using standard protective devices. Measurable doses were recorded only on the hands and forehead of the neuroradiologist. Maximum entrance skin dose was about 1 Gy on the side of the patientspatient's forehead during an endovascular procedure. Increasing the tube voltage from 75 to 85 – 85 and 90 kV, exchanging the original 0.5 mm aluminium primary filtration for 0.2 mm copper and removing the antiscatter grid allowed us to reduce entrance skin dose to the patient by 70% with unchanged or slightly improved image quality.

Download Full-text

Application of Dose Area Product (DAP) to Estimate Entrance Surface Dose (ESD) in Pediatric Chest X-Rays

Modern Health Science ◽

10.30560/mhs.v3n2p1 ◽

2020 ◽

Vol 3 (2) ◽

pp. p1

Author(s):

Roya Davoodi ◽

Mohammad-Reza Eydian ◽

Hessein Karampour ◽

Mahdi Nassarpour ◽

Reza Rezazadeh-Farokh ◽

...

Keyword(s):

Pediatric Patients ◽

Age Groups ◽

X Rays ◽

Surface Dose ◽

X Ray ◽

Dose Area Product ◽

Entrance Surface Dose ◽

Significant Difference ◽

Chest X Ray ◽

Area Product

Introduction: Given the high radiation tissue sensitivity of pediatric patients, it is necessary to monitor their received dose to optimize radiation protection. The first aim of this study was to evaluate the entrance surface dose (ESD) in pediatric patients undergoing a chest X-ray at the main hospital of Dezful, Iran. The second aim was to compare our results with the established dose reference levels (DRLs). Materials and Methods: The studied population included 204 pediatric patients less than 15 years who were referred to as chest X-ray. A calibrated dose area product meter (DAP-meter) with permanent installation on the X-ray unit was used to radiation dose measurements. For each patient, the demographic data, exposure parameters and the dose read by DAP-meter were recorded and ESD was calculated using a standard mathematical formula. Results: The average value of ESD was 119 μGy in patients less than 15 years. This value was 51.3, 122.3, 131.5 and 171.2 μGy for the age groups for less than 1 year, 1 to 5 years, 5 to 10 years and 10 to 15 years, respectively. A statistically significant difference was seen between ESD values in different age groups (P<0.001), whereas no statistical difference was seen between ESD values in girls and boys (P =0.993). Conclusion: Pediatric patients in hospital investigated (except age group less than 1 year) are subjected to unnecessary radiation exposure, especially due to the use of non-optimize X-ray protocols.

Download Full-text

Entrance Surface Dose (ESD) Measurement During Pediatric Chest X-Rays

Journal of Radiation and Nuclear Medicine ◽

10.14302/issn.2766-8630.jrnm-20-3288 ◽

2020 ◽

Vol 1 (11) ◽

pp. 23-28

Author(s):

Roya Davoodi ◽

Mohammad Reza Eydian ◽

Reza Rezazadeh- Farokh ◽

Asma Maraei

Keyword(s):

Pediatric Patients ◽

Demographic Data ◽

Age Groups ◽

X Rays ◽

Surface Dose ◽

X Ray ◽

Dose Area Product ◽

Entrance Surface Dose ◽

Significant Difference ◽

Chest X Ray

Introduction Given the high radiation tissue sensitivity of pediatric patients, it is necessary to monitor their received dose in order to optimize radiation protection. The first aim of this study was to evaluate of the entrance surface dose (ESD) in pediatric patients undergoing chest x-ray at the main hospital of Dezful, Iran. The second aim was to compare our results with the established dose reference levels (DRL). Materials and Methods The studied population included 204 pediatric patients less than 15 year who were referred to chest x-ray. A calibrated dose area product meter (DAP-meter) with permanent installation on x-ray unit was used to radiation dose measurements. For each patient, the demographic data, exposure parameters and the dose read by DAP-meter were recorded and ESD was calculated using standard mathematical formula. Results The average value of ESD was 119 μGy in patients less than 15 years. This value was 51.3, 122.3, 131.5 and 171.2 μGy for the age groups less than 1 year, 1 to 5 year, 5 to 10 year and 10 to 15 year, respectively. A statistical significant difference was seen between ESD values in different age groups (P<0.001), whereas no statistical difference was seen between ESD values in girls and boys (P =0.993). Conclusion Pediatric patients in hospital investigated (except age group less than 1 year) are subjected to unnecessary radiation exposure, especially due to use of non-optimize x-ray protocols.

Download Full-text