Abstract

Chest X-ray examination is a type of examination that is often carried out in radiology installations. Every patient who undergoes a chest X-ray examination will receive radiation exposure. The amount of chest X-ray radiation exposure depends on the exposure factors that currently refer to the manufacturer's recommendations. So, it is necessary to optimize radiation protection, which aims to reduce the radiation dose without lowering the quality of the resulting images. One way to do this is by adjusting the exposure factor while maintaining optimal image quality. The method reduces the voltage from 100 kV to 95 kV with a fixed mAs. This method was applied to a total of 100 chest X-ray patients. Each PA position has 50 patients, and AP has 50 patients. Calculations are carried out using the radiation output equation to determine changes in the patient's radiation dose. Next, qualitative and quantitative analysis was carried out to determine changes in the quality of chest X-rays before and after reducing the tube voltage and qualitatively based on a questionnaire assessment by a radiologist while quantitatively based on statistical tests of Exposure Index (S) and Lattitude (L) values on Fujifilm digital radiography. The results show that reducing the voltage can reduce the Entrance Surface Air Kerma (ESAK) from 0.2578 mGy to 0.2295 mGy. In other words, there was a reduction in the radiation dose for chest X-ray patients by 0.0283 or around 11%. Qualitatively, the image results still meet the criteria for chest image acceptance. Likewise, quantitatively, data was obtained that the S and L values of chest X-rays before and after reducing the voltage were not significantly different. The independent data difference test value is 0.598 for the PA projection and 0.809 for the AP projection with α = 0.05. The results of this study indicate that optimization of radiation protection and safety against medical exposure on chest X-rays using exposure settings can be applied by reducing the voltage (kV). Keywords: tube voltage, chest X-ray, X-ray, radiation dose, image quality, radiation protection.

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