Study of Appropriate Dosing in Consideration of Image Quality and Patient Dose on the Digital Radiography

Abstract

Recently about 90% of radiographs have been taken by the digital radiographic system in Japan, but the exposure dose of the patients are about ten-times different among the systems. We understood it by a surveytaken in 2007. We studied the visual evaluation with varying exposure doses using the image phantom of the lumber AP, lumber lateral and hip AP. Additionally we measured quantum efficiency (DQE) of the digital systems. We also studied the exposure index (EI) of IEC standard to see whether it is able to be the sensitivity index among the digital systems. DQE in 1.0 cycle/mm of CR, FPD (GOS), FPD (CsI, a-Se) became 0.2-0.25, 0.3, 0.5, respectively. Our results display that the dose reduction is relative to DQE. The visual evaluation results also show that dose reduction is possible among the systems. From these results, we are able to reduce the exposure dose of the patients at the clinical site. We also suggest that we manage the exposure dose using the E.I of the IEC standard.

Survey of patient exposure from general radiography and mammography in Japan in 2014

“…Compared with our own 2011 study of the ESDs during chest and lateral lumbar spine examinations with CR and FPD devices [7], the ESDs(CR:9.75 mGy, FPD:6.01 mGy in 2011) for lateral spine examinations have decreased in CR device, whereas those for chest examinations(CR:0.29 mGy, FPD:0.20 mGy in 2011) have risen. Studies of the appropriate exposure dose for chest examinations in light of both the quality of digital images and exposure dose are currently underway [14], and these may yield better results in future.…”

Proposed diagnostic reference levels for general radiography and mammography in Japan

“…DRLs are not dose limits, and can thus be exceeded in the event of clinical necessity. The lower level of the proposed DRLs compared to the DRLs 2015 therefore cannot be unequivocally attributed to application of the DRLs 2015, and the report by Kishimoto et al [21] indicates that appropriate use of FPD systems, which are higher in detective quantum efficiency than CR systems, leads to dose reduction, and the rates of FPD use in general radiography fields and mammography exceeded 50% in 18 of the 20 radiography modes in the present survey and reached 61.2% and 63.6% in chest radiography and mammography, respectively, approximately double the levels of 34.6% and 45.2% found in the 2014 survey by Asada et al [11].…”

JCS 2021 Guideline on Radiation Safety in Cardiology

“…Furthermore, in recent years, digital imaging such as computed radiography (CR) and flat panel detector (FPD) have replaced analog imaging with film in most cases, and some reports suggest that FPD imaging can further reduce exposure doses compared with film and CR. 115 However, it is common for patients treated in the intensive care unit to undergo chest X-ray almost every day. Even though each dose for imaging may be low, it will add up over time.…”

“…PatientsLatest imaging modalities should be considered115 IIa BRisk of exposureIt is recommended that risk communication be tailored to the individual patient and family situation116-118 I C COR, Class of Recommendation; LOE, Level of Evidence.…”