Patient Doses in Common Diagnostic X-Ray Examinations

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.

Local diagnostic reference levels for routine chest X-ray examinations at a public sector hospital in central South Africa

“…Table 6 shows a summary of this study’s LDRL values that they were lower than those of international organisations (EC 2018 ; IAEA 2004 ) and other previously published studies (Ahmed et al 2020 ; Baş Mor et al 2018 ; Hart et al 2012 ; Hoseini Motlagh et al 2020 ; Metaxas et al 2019 ; Mohsenzadeh et al 2018 ; Nyathi et al 2009 ; Suliman 2020 ). The reason for this is that the radiographers at the research site used the high kVp and low mAs technique to produce chest X-ray radiographs.…”

“…The patients who were selected to participate in this research weighed from 60 kg to 80 kg. The weight ranges of the comparable DRL studies were from 50 kg to 105 kg (Ahmed et al 2020 ; Baş Mor et al 2018 ; Hart et al 2012 ; Hoseini Motlagh et al 2020 ; Metaxas et al 2019 ; Mohsenzadeh et al 2018 ; Nyathi et al 2009 ; Suliman 2020 ). As the body weight increases, so does the radiation dose to the patient, and vice versa.…”

“…However, when comparing ESAK values, the Iranian ESAK values were higher than our findings. Hoseini Motlagh et al 2020;Metaxas et al 2019;Mohsenzadeh et al 2018;Nyathi et al 2009; Suliman 2020). The reason for this is that the radiographers at the research site used the high kVp and low mAs technique to produce chest X-ray radiographs.…”

Chiropractic students’ experiences on the use of virtual radiography simulation: a pilot observational study

“…According to the literature, no other chiropractic institution or training program has implemented simulated radiography in their curriculum. Since completing this pilot study; however, literature has been published on the use of other virtual radiography software [ 10 , 11 ]. The Projection VR TM software has been well described by Shanahan [ 9 ].…”

Effects of Medical Diagnostic X-rays Delivered at 0.01 or 0.05 mGy on Human Blood Cells

“…Low-dose radiation from computed tomography and mammography is associated with absorbed doses higher than 1.0 mGy. However, evidence on the biological effects from exposure to diagnostic low-dose radiation for general radiography that is associated with absorbed dosages of less than 0.1 mGy 24,25 , such as skeletal extremity radiography, is lacking. As a beginning step to fill this information gap, we determined the effects of medical diagnostic low-dose radiation (0.01 or 0.05 mGy) after an in vitro exposure of human blood cells: red blood cells (RBCs) and peripheral blood mononucleated cells (PBMCs).…”