Abstract
Diagnostic reference levels (DRLs) for X-ray procedures have been established in many countries since 1996. In Peru, data from the literature are used as guidelines as DRLs research is limited. The objective of this study is to analyze the parameters and variables which are used in radiological techniques such as kV, mAs, and type of machine (conventional or digital); study the geographical distribution of radiological X-ray machines, and establish DRLs in Peru. Two radiological procedures were considered, general X-rays (fixed and mobile) and intraoral X-rays (fixed, mobile, and portable). An Unfors RaySafe Xi detector (Unfors RaySafe AB, Billdal, Sweden) was used; air kerma was measured at a source to image distance that varied depending on the procedure, and the entrance skin dose was subsequently calculated using the Arcal XLIX formalism. The data were collected over a period of three years (2015-2017). Only results from the last evaluation during this period were taken into consideration for each X-ray machine. DRLs were calculated at 0.21 mSv, and 0.25 mSv for posterior-anterior chest examinations in conventional and digital machines, respectively; 4.39 mSv and 6.01 mSv for conventional and digital antero-posterior lumbar spine examinations, respectively; and at 4.21 mSv for the dental intraoral procedure. The largest amount of X-ray machines is concentrated in the city of Lima. These results reflect the standard of practice in Peru.
Highlights
The absorbed dose, in matters of ionizing radiation, is the energy deposited per kilogram and it is represented by the Gray (Gy) in the international system of units
In Peru, law 28028 [7], with its technical standard IR 0032013, stipulates that the representative doses for patients must be determined for different radiographic procedures and that X-ray examinations must comply with the principles of justification, and optimization [8]
In order to calculate the Diagnostic reference levels (DRLs) for common general radiology techniques (PA Chest and anteroposterior lumbar spine (AP) Lumbar Spine) and dental - intraoral examinations [13,14], the entrance skin dose was calculated with the data obtained from an Unfors RaySafe Xi detector with the method recommended by the Arcal XLIX protocol (Equation 1) [12]
Summary
The absorbed dose, in matters of ionizing radiation, is the energy deposited per kilogram and it is represented by the Gray (Gy) in the international system of units. When the absorbed dose is multiplied by a weighting factor that depends on the type of radiation, it is known as the equivalent dose and its unit is the Sievert (Sv). The diagnostic reference level (DRL) value was first introduced in publication 73 of the International Commission on Radiological Protection (ICRP) [5]. In Peru, law 28028 [7], with its technical standard IR 0032013, stipulates that the representative doses for patients must be determined for different radiographic procedures and that X-ray examinations must comply with the principles of justification, and optimization [8]. Research in Peru for the establishment of DRLs is limited [9]
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