Investigation of the entrance dose of standardized chest radiographs

Abstract

In 50 chest radiographs obtained in PA projection with the patient erect and the radiographic techniques kept constant, entrance dose, entrance surface dose and dose area product were measured and compared with the measurements obtained with Plexiglas and Alderson phantoms. Following the recommendations of the International Commission on Radiological Protection, the "absorbed dose in air" at the point of intersection of the X-ray beam with the surface of the patient was used as reference. For patients with the same diameter, the measured dose deviated up to +/- 50 % from the "Reference Man" according to the ICRP 23 as well as from the "Representative Patient" according to the ICRP 73. The exposure data produced by the equipment corresponded to the measured values with minor deviations, but the dose values expressed as entrance surface dose showed major deviation in comparison with the entrance dose due to differences in the back-scatter factor. The values of entrance dose calculated from the dose area product measurements showed additional uncertainties due to different field sizes. Moreover, a sex-specific dose area product value was identified. These results reveal that the values of the "ICRP Reference Man" differ in many situations from the values produced by the examined patient due to differences in radiation transmission. This has consequences for determining diagnostic reference values and investigating recorded radiation exposure. This will be explained and substantiated.