Lumbar Spine Radiography: Lower Organ Dose With the Use of Pa Projection

Abstract

The purpose of the research was to determine the effect of the posteroanterior (PA) patient position in lumbar spine imaging on effective dose and the absorbed organ dose. The study was performed on 100 patients that were referred to the lumbar spine radiography that were divided into two equal groups of 50. Body Mass Index, Dose Area Product (DAP), exposure index (EXI), tube time-current (mAs), image field size and the source-patient distance were acquired for each patient. The entrance surface dose (ESD), the effective dose and the absorbed organ doses were calculated. There was no statistically significant difference in the BMI and EXI between the AP and PA projection. The results showed a significant reduction of ESD by 33% and the effective dose by 53% when the PA projection was used. Furthermore, there was a 64% average reduction of the absorbed organ doses to the selected organs.

Optimisation of Radiographic Procedures – Lumbar Spine Imaging in General Radiography

“…Papers describing optimisation techniques in lumbar spine radiography have been studied in several countries around the world. Those countries are Finland (16), Australia (17,34,39,41), Ireland (18,19,21,22,25), China (20), Sweden (24,26,33), Kuwait (23), United Kingdom (27,30,36), Slovenia (28,35,37), Iran (29,32), Israel (31), Croatia (38) and Malta (40).…”

“…The research methodology was experimental in almost all studies, except for three studies (16,32,39) in which the research methodology was a retrospective study of lumbar spine images. In most cases, the research was performed on an anthropomorphic phantom (17,20,34,41,(22)(23)(24)(25)(29)(30)(31)33), in a few studies the research was performed on patients only (27,(36)(37)(38), and some of them performed a combined study fi rst on a phantom and then on patients (18,19,21,26,28,35,40). The sample size of the examined patient studies varied from study to study.…”

“…The investigators studied the radiation dose to the patient and/ or phantom in all papers, but the measurement tool for the dose measurements varied from study to study. The dose was measured using TLDs (16,(18)(19)(20)(21)(22)25,28,33), ionization chambers (17,26,30), with some mathematical formulas and using conversion factors (21,23,32), DAP meters (27,35,36,38,40), based on calculations with the PCXMC program and Monte Carlo simulation (24,(29)(30)(31)(35)(36)(37)(38)41) and other ways (24,29,34). Image quality was not checked in a large number of the papers examined (17,20,34,37,(25)(26)(27)(28)(29)(31)(32)(33).…”

“…The dose was measured using TLDs (16,(18)(19)(20)(21)(22)25,28,33), ionization chambers (17,26,30), with some mathematical formulas and using conversion factors (21,23,32), DAP meters (27,35,36,38,40), based on calculations with the PCXMC program and Monte Carlo simulation (24,(29)(30)(31)(35)(36)(37)(38)41) and other ways (24,29,34). Image quality was not checked in a large number of the papers examined (17,20,34,37,(25)(26)(27)(28)(29)(31)(32)(33). There were several ways to achieve dose optimisation in lumbar spine radiography.…”

“…There were several ways to achieve dose optimisation in lumbar spine radiography. In 7 papers, the researchers used diff erent tube potentials (kV) (21)(22)(23)(24)34,39,41), diff erent mAs (41), in 5 papers they used alternative positioning of the patient, in which the patient or phantom was rotated to diff erent positions (19,27,(29)(30)(31)(35)(36)(37), and 2 studies used lead shielding as a method of radiation dose reduction (25,28). Four papers investigated increasing the distance (focus-fi lm distance and source-to-image distance) on the radiation dose to the patient during lumbar spine radiography (17,18,22,41), and some of the papers evaluate the eff ect of proper collimation (32,33,38).…”