Abstract
One of the principles of radiation protection is optimization. Optimization is done to make the dose received as low as reasonably achievable (ALARA) by considering economic and social factors. Implementation of radiation protection optimization can be done with dose management through the Local Diagnostic Reference Level (DRL). In recent years, the Nuclear Energy Regulatory Agency (BAPETEN) has set the Indonesian DRL value for several X-ray modalities, including dental panoramic. This study was motivated by panoramic patient dose audit data using the auto mode exposure factor, which operators often use. The method for determining the manual mode exposure factor is carried out by comparing the image quality of the current variations of 6.3 mA, 8 mA, 10 mA, 13 mA, and 16 mA with a fixed voltage of 66 kV and a time of 14.1 seconds. The local DRL value was obtained by comparing the dental panoramic auto mode measurements with manual mode using certain exposure factors according to the recommendations in the initial study using a head phantom. This study used 100 patient data with adult human criteria aged over 15. The results obtained from the initial study and questionnaires in manual mode were the values that had the highest CNR and SNR at a current variation of 10 mA. The exposure factor was then used to collect patient data. The local DRL value obtained for auto mode was 83.35 mGy cm2; in manual mode, it was 57.7 mGy cm2. Manual mode exposure factors in dental panoramic examinations affected the implementation of local DRL values with a decrease of 30.77% from auto mode. The use of manual mode in dental panoramic examinations significantly reduces the radiation dose received by patients, so the use of manual mode is one of the steps to optimize radiation protection. Keywords: Diagnostic Reference Level (DRL), optimization of radiation protection in patients, dental panoramic.
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