Investigation on entrance surface doses to patients from medical X-ray diagnosis in Guangxi

Objective To acquire the basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical radiation of Hebei province in 2016. Methods A survey was made using questionnaires for basic information on medical X-ray diagnosis, interventional radiology, radiotherapy and clinical nuclear medicine. Values of frequencies were derived for each type of medical X-ray procedure by dividing the total population. Results In 2016 there were 2 951 institutions at province level and 6 966 pieces of equipment involved in diagnostic radiology and radiotherapy treatments. Frequency values were estimated to be 379.25 examinations per 1 000 population in medical X-ay diagnosis, 2.31 per 1 000 in interventional radiology, 0.55 per 1 000 in radiotherapy and 1.65 per 1 000 in clinical nuclear medicine. The frequency for CT examination was 136.39 per 1 000, accounting for 36% of the total frequencies in the province, with average annual growth rate of 12.4%. The highest value of frequency in clinical nuclear medicine was from Shijiazhuang among all types of medical procedures in different regions, 11 times higher than the lowest value found in Hengshui city. Although the number of tertiary hospitals only accounted for 2.3% of the total number of institutions, they contributed 25.5%, by examination number, of the medical X-ray diagnosis and 35.3% of the CT examination. Interventional radiology and radiotherapy contributed more than 70% of the total frequencies in the province, and clinical nuclear medicine was as high as 97.7%. Conclusions The basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical procedures in Hebei in 2016 have been preliminarily made clear. Medical exposure could maintain a long-term growth trend. The frequency distribution of medical procedures in various regions and medical institutions is highly unbalanced. It is desirable to enhance the macroeconomic regulation and the management of medical radiation protection in order to rationally perform all types of diagnostic radiology and radiotherapy treatments to protect the health and safety of the patients and the examined individuals, and to promote the sustainable development of the health care services. Key words: Medical exposure; Frequency; X-ray diagnosis; Interventional radiology; Nuclear medicine

Objective To survey the frequency of medical X-ray diagnosis and estimate the medical exposure levels of Jiangsu province in 2016, so as to be able to improve effectively the protection against medical radiation exposure. Methods All medical institutions in the province were covered in the survey for their basic medical information by means of census method . Frequencies of diagnostic medical X-ray examination were studied using random sampling method in 31 medical institutions. A linear model was established by number of outpatients number of inpatients, number of staff and number of radiation workers to evaluate the medical examination frequency. Results A total of 9 248 pieces of medical X-ray diagnostic equipment by the end of 2016 in Jiangsu province, including 1 110 CT scanners. The total frequencies of diagnostic medical X-ray examination were estimated to be 911.45 examinations per 1 000 population, covering 239.25 per 1 000 for CT scanning. The number of medical X-ray diagnostic equipment increased by a factor of 0.8 while CT scanners by a factor of 3.6 compared to 1999. Medical X-ray diagnostic frequency raised by a factor of 3.2 while CT frequency by a factor of 15.1 compared with previous data. Conclusions The medical X-ray diagnostic frequencies in Jiangsu province was 1.9 times the value given in the UNSCEAR 2008 Report, close to those in some developed European countries. Compared with the study in 2015, the present study has made greater improvement in sampling technique for selection of hospitals and equipment, frequency estimation method and acquisition of influence factors. Estimates of medical X-ray diagnosis frequency are closer to actual level. Further improvement will be needed for the future survey, so as to further study medical exposure levels and to provide basic information for better patient protection. Key words: Medical X-ray diagnosis; Medical exposure; Frequency; Examinee; Radiological protection

Objective To scale the frequencise of medical X-ray diagnosis based on the survey conducted in 58 hospitals to the all hospitals in Henan province, in order to make them available for providing the basis for reasonable application of diagnostic radiology. Methods Stratified sampling method was used to select medical institutions at different levels in 6 cities in the province as sample hospitals. The information of examined patients on sex, age, diagnostic type and exposure category were gathered and the results were analyzed. Results The sex ratio of male and female examined patients was close to 1∶1. The largest proportion, 60.47%, of examined patients was from the age group of above 40 years old among the three age groups. Medical diagnositc medical X-ray examinations mainly include conventional X-ray photography and CT examination, accounting for 52.15% and 40.31%, respectively. Chest examination contributed the largest propotions, 23.84%, of conventional diagnositic X-ray examination and, 13.25%, of CT examination respectively. CT examinations were mainly concentrated in the secondary and tertiary hospitals, accounting for 21.54% and 72.99% of the total CT examinations, respectively. Contrast examination, mammography and extracorporeal lithotripsy were concentrated in the tertiary hospitals, accounting for 77.82%, 95.01% and 100% of the same type of examinations, respectively. Conventional photographic examinations were mainly conducted in primary hospitals, accounting for 74.56% of all types of examinations in the primary hospitals. By using multiple linear regression model, the diagnostic examination frequency in 2016 was estimated to be 826 examinations per 1 000 population, of which the frequency of dianostic X-ray examination and CT examination were 541 per 1 000 and 285 per 1 000, respectively. Conclusions The frequency of diagnostic radiology in Henan has increased rapidly in recent years. All types of diagnostic radiology equipment are unevenly distributed in hospitals at different levels which posed a challenge for health care. Relevant departments should make efforts to reallocation of diagnostic radiology equipment in such hospitals and make utilization of health resources more reasonable. Key words: Medical X-ray diagnosis; Medical exposure; Frequency

The modulation transfer function, noise power spectrum and sensitometric response which are the most significant parameters for characterising the image information transfer efficiency of screen-film systems have been determined experimentally on various systems used in medical X-ray diagnosis. By use of an equation introduced by Dainty and Shaw /2/ the Detective Quantum Efficiency DQE has been calculated from these parameters. In particular the low spatial frequency aspects of the noise power spectrum and of the DQE, which are the ones most relevant in medical X-ray diagnosis, will be considered in more detail.

Objective To study the frequency of diagnostic medical radiological examinations and the distribution of examinees in Jiangxi province by sampling investigation, including normal X-ray diagnosis, computed tomography (CT), interventional radiology. Methods Hospitals of different levels in Jiangxi province were chosen by the typical sampling method. Questionnaire was used in this study. Results There were more male examinees than female in diagnostic medical radiological examinations. For the distribution of age, the 0- group accounted for the lowest and the 40- group the highest proportion. The annual frequency in 2016 in Jiangxi was 543.07 examinations per 1 000 population for normal X-ray diagnosis, 244.79 examinations per 1 000 population for CT scanning, 6.28 examinations per 1 000 population for interventional radiology. Conclusions The frequency of diagnostic medical radiological examinations in Jiangxi has been increased rapidly which made a huge challenge for radiological protection. Therefore, the supervision and management of diagnostic medical radiological examinations should be enhanced and medical resources should be rationally allocated. Key words: Medical X-ray diagnosis; Medical exposure; Frequency

Objective To obtain the information on frequency of diagnostic medical X-ray examination and age distribution of examined individuals surveyed through samples from 12 hospitals in Inner Mongolia region to provide the basis for the optimization of medical exposure. Methods Stratified sampling method was used to select 12 hospitals in the region to survey the information of examined patients on sex, age and exposed location of patients undergoing medical X-ray examination in 2015 and 2016. Based on the information on number of inpatients, number of inpatients and total number of staff, the total frequency of medical X-ray examinations in the region for 2015 and 2016 was estimated by using multiple linear regression model. Results The survey showed that the total frequency of medical exposure was, in decreasing order, tertiary hospitals > secondary hospitals > primary hospitals, and meanwhile the general hospitals > specialized hospitals. Values on frequency in general hospitals in 2015 and 2016 were 223 examinations per 1 000 population and 233 per 1 000 in conventional X-ray examination, 96 per 1 000 and 125 per 1 000 in CT examination, 1 per 1 000 and 2 per 1 000 in fluoroscopy, 35 per 1 000 and 19 per 1 000 in dental radiology, 1 per 1 000 and 2 per 1 000 in breast fluoroscopy in the region, respectively. Conclusions The frequency of radiological diagnosis and treatment in Inner Mongolia showed an rapid upward trend, but varied greatly dependent on the levels and types of medical institutions. Further surveys should be expanded with focuses on their comprehensiveness and relevancy. Key words: Medical exposure; Frequency; X-ray diagnosis

This article analyzes current challenges in medical X-ray diagnosis. The design of a tunnel-type ionization chamber for recording dose and dose power over a wide range of bremsstrahlung radiation energies is discussed. We address questions related to the standardization of apparatus and the creation of a universal digital platform for X-ray radiotherapy instruments as the basis for building state-of-the-art, productive, safe, and reliable radiotherapy instruments with different operating modes in terms of power supply voltage and power, from kilowatts to tens of kilowatts. The article also considers the state of X-ray diagnosis in general and the quality of X-ray apparatus; the challenge of measuring technogenic radiation doses to patients; the use of digital technologies providing digital images of quality no less than and even greater than that of film-based images combined with significant reductions in effective doses during investigations, and the advantages of computer processing; the treatment of nosological groups of diseases by radiotherapy; the needs for radiotherapy systems based on medical linear electron accelerators; radiation safety for staff and the population; small-scale, mobile devices for X-ray investigations in patients; and legal and technical aspects. A special program for assessing the detective quantum efficiency of dynamic digital X-ray image detectors is proposed.

The need to re-examine radiation protection and safety measures to protect the people in Ghana is therefore essential. This is because medical X-ray diagnosis in the country continues to increase. It is the responsibility of the radiation worker to protect patients, self, staff and the members of the public against unnecessary exposure to ionizing radiation. Medical radiation protection is an important aspect of quality care that X-ray departments are expected to provide for their patients. Following increasing concern about radiation hazards from medical diagnostic x-ray, radiation dose assessment of patients undergoing medical diagnostic x-ray examinations has been suggested. However, to implement them requires an effective infrastructure which includes adequate laws and regulations, efficient regulatory system, experts on radiation protection and operational provisions.

Objective To obtain the information on the frequency of diagnostic X-ray examinations in Guangdong province in order to provide reference data for the rational application of diagnostic radiology. Methods A typical stratified sampling method was used to select 56 medical institutions in 7 districts in Guangdong province for the survey of the frequencies of diagnostic X-ray examinations. Multiple linear regression analysis was performed using the relevant variables of the surveyed sample (total number of hospitals, number of outpatients, number of inpatients, number of radiation workers, and number of diagnostic equipment). The dependent independent variables were fitted to the linear regression equation to estimate the frequency of routine diagnostic X-ray examinations and diagnostic CT examinations and the total frequency of diagnostic medical X-ray examinations in Guangdong province in 2016. Results By the largest percentage contribution, chest radiography accounted for 60.84% of the routine diagnostic X-ray examinations, brain scans 28.03% of diagnostic CT examinations, and cardiovascular interventions 48.83% of interventional radiology. For the group of above 40 years old, the largest percentage contributions were, respectively, routine diagnostic X-ray examination 47.95%, diagnostic CT examinations 65.41%, and interventional radiology 75.64%. All types of medical X-ray examinations are concentrated in the tertiary and secondary hospitals. Based on this survey, the examination frequencies for 2016 in Guangdong were estimated to be, respectively, diagnostic X-ray examination 699 examinations per 1 000 population and CT diagnostic 231 examinations per 1 000 population, with the total of 992 examinations per 1 000 population. Conclusions This survey was completed to a limited degree and less investment. The results showed that the diagnostic radiology in Guangdong province is developing with increased frequencies, with wide varieties of X-ray examination types in the tertiary and secondary hospitals. Relevant competent departments should pay attention to strengthening the radiation protection of examined individuals and actively providing guidance on the correct and rational application of diagnostic radiology so as to achieve profit and avoid disadvantages. Key words: Diagnostic radiology; Medical exposure; Frequency

A description is given of the results of a series of tests on the ferrite serving as a contrast medium for the medical X-ray diagnosis. The solubility of ferrite in the artificial gastric juice and intestinal juice, the toxicity, the X-ray absorption, the magnetic field strength required for controlling the ferrite powder as well as the applicability of the ferrite to actual diagnoses were examined. Manganese zinc ferrite powder containing a small amount of oxide of barium, tungsten or cerium and sintered at a temperature as high as 1200°C or more has been shown to have a property good enough to be used in actual practice.

HomeRadiologyVol. 158, No. 3 PreviousNext ReviewsCriteria and Methods for Quality Assurance in Medical X-ray DiagnosisHarry GriffithsHarry GriffithsHarry GriffithsPublished Online:Mar 1 1986https://doi.org/10.1148/radiology.158.3.818MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: Mar 1986 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 158, No. 3 Metrics Altmetric Score PDF download

5 - X-Ray Detectors

Effectiveness of an X-ray shielding sheet with lower shielding ability to enable both bone mineral density determination and morphological diagnosis

Introduction to Physics in Medical X-ray Diagnosis

Polymer semiconductors are promising candidates for wearable and skin-like X-ray detectors due to their scalable manufacturing, adjustable molecular structures and intrinsic flexibility. Herein, we fabricated an intrinsically stretchable n-type polymer semiconductor through spatial nanoconfinement effect for ultrasensitive X-ray detectors. The design of high-orientation nanofiber structures and dense interpenetrating polymer networks enhanced the electron-transporting efficiency and stability of the polymer semiconductors. The resultant polymer semiconductors exhibited an ultrahigh sensitivity of 1.52 × 104 μC Gyair−1 cm−2, an ultralow detection limit of 37.7 nGyair s−1 (comparable to the record-low value of perovskite single crystals), and polymer film X-ray imaging was achieved at a low dose rate of 3.65 μGyair s−1 (about 1/12 dose rate of the commercial medical chest X-ray diagnosis). Meanwhile, the hybrid semiconductor films could sustain 100% biaxial stretching strain with minimal degeneracy in photoelectrical performances. These results provide insights into future high-performance, low-cost e-skin photoelectronic detectors and imaging.