Collective Effective Dose from Medical Radiation Use in Indonesia: Si-INTAN Data Study Period 2018-2021

Abstract

Until now, there has been no information regarding the value of the collective dose per procedure using the X-ray modality in Indonesia. As in the ICRP 103 publication (2007), it is stated that the collective effective dose is an instrument for optimizing protection by comparing radiological technology and the protection procedures that will be taken. This article aims to raise awareness and optimize the use of diagnostic X-ray modalities by providing an estimate of the proportion of Indonesia's total population compared to the number of radiation examinations carried out, the collective annual effective dose, and the potential risks. The information provided is based on a data reported to the Patient Dose Data Information System (Si-INTAN) application from 2018 to 2021. The data is in the form of the number of patient examinations per modality and the national Diagnostic Reference Level (DRL) value for each type of procedure. From the results of the analysis, it was found that the proportion of patient examinations per modality in the sequence was conventional radiology (79.19%), CT Scan (17.56%), dental radiology (1.75%), interventional fluoroscopy (0.70%), medical diagnostic nuclear (0.62%), and mammography (0.18%). The majority of the annual collective effective dose in Indonesia comes from CT Scan (97.45%), interventional fluoroscopy (1.30%), conventional radiology (0.86%), diagnostic nuclear medicine (0.38%), and a small percentage from mammography and dental radiology. It is estimated that around 116.6 million Indonesians receive radiation exposure for medical needs with a collective annual effective dose of 860,000 man-Sv. This collective effective dose provides an estimate of the incidence of cancer in the Indonesian population of around 0.016% of the entire population in 2021. This information can be used as a baseline to evaluate trends in using and monitoring ionizing radiation sources for medical imaging needs in Indonesia. Keywords: effective dose, collective effective dose, diagnostic reference level (DRL), radiation imaging, diagnostic X-rays, radiation protection