Patient Dose Reduction in Some Routine Radiographic Examination in Iran

Abstract

The purpose of this study was to survey image quality and the entrance surface air kerma for patients in radiographic examinations and to perform comparisons with diagnostic reference levels. In this study, image quality and patient radiation doses were surveyed in 50 hospitals from different proviences in Iran. The rate of unsatisfactory images and image quality grade were noted, and causes for poor image quality were investigated. The entrance surface doses for adult patients were determined in terms of the entrance surface air kerma on the basis of X-ray tube output measurements and X-ray exposure parameters. Comparison of dose levels with diagnostic reference levels was performed. The image quality improved up to 10 percentage points in different hospitals after implementation of a quality control (QC) program. Patient doses varied by a factor of up to 22, although the majority of doses were below diagnostic reference levels. The mean entrance surface air kerma values in mGy before QC were 0.48 (chest, posterior-anterior), 3.4 (lumbar spine, anterior- posterior(AP)), 8.81 (lumbar spine, lateral), 3.56 (abdomen, AP), 2.79 (pelvis, AP), 2.27 (skull, AP) and 1.5 (skull , lateral) and after QC were 0.37 (chest, AP), 3.13 (lumbar spine,AP), 7.56 (lumbar spine, lateral), 3.34 (abdomen, AP), 2.71 (pelvis, AP), 2.1 (skull, AP) and 1.43 (skull , lateral) . Patient doses were found to be similar to doses in developed countries and patient dose reductions ranging from 3% to 23% were achieved. Comparison with other surveys indicates that patient dose levels in these hospitals are not higher than those in developed countries.