Breast organ doses, effective doses and lifetime attributable risk (LAR) of breast cancer from chest CT scans are presented for 200 female patients surveyed from 10 hospitals in the West Bank and Gaza Strip, Palestine. Patient data were collected and organized in a database from May to November 2016. Data include age (15-80 years), weight, height, and calculated body mass index. Exposure data were also recorded for every examination. Exposure data includes milliampere-second (mAs), X-ray tube kilovoltage (kVp), computed tomography dose index, dose length product, manufacturer, name and type of operated CT scanner. Organ and effective doses were evaluated using a web-based commercially available Monte Carlo software: VirtualDose™CT, a product of Virtual Phantoms, Inc. The software utilizes male and female tissue equivalent phantoms of all ages and sizes including pregnant patients. The corresponding phantom was selected for every patient according to patient's tomographic parameters. Calculated organ doses were used to estimate the LAR of breast cancer according to BEIR VII Phase 2 report. It was found that radiation doses resulting from the same exam vary widely between different hospitals, depending on the parameters used and the type of scanner. For all patients, the breast organ dose ranged from 6.5 to 28 mGy per examination, with an average breast organ dose of 15 mGy. The effective dose from chest CT scan per examination ranged from 3 to 14.7 mSv with an average of 7 mSv. For younger females (15-29 years), the LAR of breast cancer risk was estimated to be around 0.05%. For older female patients (60-79 years), the risk was ~0.001%. It was found that LAR decreases remarkably with patient's age. Values obtained in this study vary between hospitals, they are generally low and consistent with other studies reported worldwide.
The ionization chamber is a primary dosimeter that is used in radiation dosimetry. Generally, the ion chamber response requires temperature/pressure correction according to the ideal gas law. However, this correction does not consider the thermal volume effect of chambers. The temporal and thermal volume effects of various chambers (CC01, CC13, NACP parallel-plate, PTW) with different wall and electrode materials have been studied in a water phantom. Measurements were done after heating the water with a suitable heating system, and chambers were submerged for a sufficient time to allow for temperature equilibrium. Temporal results show that all chambers equilibrate quickly in water. The equilibration time was between 3 and 5 min for all chambers. Thermal results show that all chambers expanded in response to heating except for the PTW, which contracted. This might be explained by the differences in the volumes of all chambers and also by the difference in wall material composition of PTW from the other chambers. It was found that the smallest chamber, CC01, showed the greatest expansion. The magnitude of the expansion was ~1, 0.8, and 0.9% for CC01, CC13, and parallel-plate chambers, respectively, in the temperature range of 295-320 K. The magnitude of the detected contraction was <0.3% for PTW in the same temperature range. For absolute dosimetry, it is necessary to make corrections for the ion chamber response, especially for small ion chambers like the CC01. Otherwise, room and water phantom temperatures should remain within a close range.
Radiation doses to patients resulting from chest X-ray examinations were evaluated in four medical centers in the West Bank and East Jerusalem-Palestine. Absorbed organ and effective doses were calculated for a total of 428 adult male and female patients by using commercially available Monte Carlo based softwares; CALDOSE-X5 and PCXMC-2.0, and hermaphrodite mathematical adult phantoms. Patients were selected randomly from medical records in the time period from November 2014 to February 2015. A database of surveyed patients and exposure factors has been established and includes: patient's height, weight, age, gender, X-ray tube voltage, electric current (mAs), examination projection (anterior posterior (AP), posterior anterior (PA), lateral), X-ray tube filtration thickness in each X-ray equipment, anode angle, focus to skin distance and X-ray beam size. The average absorbed doses in the whole body from different projections were: 0.06, 0.07 and 0.11 mGy from AP, PA and lateral projections, respectively. The average effective dose for all surveyed patients was 0.14 mSv for all chest X-ray examinations and projections in the four investigated medical centers. The effect of projection geometry was also investigated. The average effective doses for AP, PA and lateral projections were 0.14, 0.07 and 0.22 mSv, respectively. The collective effective dose estimated for the exposed population was ~60 man-mSv.
Occupational radiation dose monitoring is a method of ensuring that radiation levels are within the regulatory limits. Our objective in this study was to evaluate the radiation doses experienced by personnel at a radiology facility between 2001 and 2010. Overall, 2418 annual dose records for workers who were categorized into four occupational groups were analyzed. The groups included: (1) radiologists, (2) radiologic technologists, (3) nurses, and (4) other workers, who belong to other hospital departments, but who participate partially in some radiologic procedures. The dose distribution was found to be skewed, with 76 % of personnel having received no measurable doses and almost 2 % having received doses of more than 2 mSv. The weighted-average annual doses ranged from 0.13 to 0.57, 0.9 to 2.12, 0.01 to 0.19, and 0.01 to 0.09 mSv for the radiologists, radiologic technologists, nurses, and the other workers, respectively. The radiologic technologists received the highest radiation exposure among the four groups. It was found that the average annual doses were decreasing over time for the radiologists, radiologic technologists, and others, whereas they were increasing for the nurses. Nurses play an important role in assisting radiologists and patients during various radiologic procedures, which might have increased their average annual dose. During the 10-year period of this study, there was no incidence of a dose exceeding the annual dose limit of 20 mSv. Furthermore, there was no detectable neutron exposure.
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