How does a non-optimal tube potential influence radiation dose to the patient in lumbar spine radiography?

Abstract

IntroductionWhen comparing the radiation dose to the patient, the lumbar spine has one of the highest dose values in general radiography, therefore the procedure needs to be optimised. The aim of this study was to investigate the effect of a non-optimal tube potential (66 kV) during anteroposterior (AP) lumbar spine radiography on the radiation dose received by the patient compared with the radiation dose when an optimal tube potential (79 kV) is used, in accordance with European guidelines. MethodsThis retrospective study involved 100 patients referred for lumbar radiography in two different diagnostic departments. Half of the patients were admitted to a department which used optimal tube potential and the other half to the department which used non-optimal tube potential for AP lumbar spine radiography protocols. The height and weight of the patients were collected to calculate the body mass index (BMI) of the patients. The image field size and dose area product (DAP) values were collected after each imaging session. The effective dose and selected organ dose were calculated using the PCXMC 2.0 program. ResultsThe results showed that a non-optimal tube potential resulted in a significant increase in the DAP value by 360% (p < 0.001) and a significant increase in the effective dose by 160% (p < 0.001). Dose to selected organs due to non-optimal tube potential increased from 107% (breasts) up to 631% (prostate) (p < 0.001). The images were not assessed using visual grading characteristics (VGC) analysis, but the radiologists evaluated all the images appropriate for diagnostic reading. ConclusionBased on our study's stated results, we can conclude that optimal tube potential use is essential to achieve the ALARA principle. Implications for practiceThe study shows the effect of a non-optimal tube potential on the radiation dose received by the patient during radiography of the lumbar spine. This could influence possible diagnostic departments to consider protocol optimisation due to the high radiation dose received by the patient.