Abstract
Purpose: To assess the radiation doses to neonates from diagnostic radiography in order to derive the local diagnostic reference levels (LDRLs) for optimisation purposes. Methods: This study was carried out in the neonatal intensive care units (NICU) of two hospitals in Tunis. 134 babies, with weights ranging from 635 g to 6680 g, performed chest-abdomen X-ray examinations. Neonates were categorized into groups of birth weight. For each X-ray examination, patient data and exposure parameters were recorded. Dose area product (DAP) was measured and entrance surface dose (ESD) was estimated. Effective dose was calculated from the Monte Carlo simulation software PCXMC. Results: DAP values increased with neonatal weight and demonstrated a wide variation (5.0 - 43.0 mGy.cm 2 , mean 23.4 mGy.cm 2 ) for patient weight from 600 g to 4000 g. A wide variation was also observed for ESD (14 - 93 μGy, mean 55.2 μGy). The LDRLs expressed in term of DAP were estimated to be 17.6 mGy.cm 2 and 29.1 mGy.cm 2 for the first and the second NICU, respectively. In terms of effective dose, the average value was about 31.6 μSv per single radiological examination. The results show the necessity to use a standardized protocol with high voltage technique combined to lower current time product (mAs) values and an adapted collimation which could lead to further reductions in the neonatal doses. Conclusion: This study presents the LDRLs and the effective doses for neonates in two NICUs and demonstrates the necessity to optimize patient protection for this category of patient.
Highlights
Sick and premature neonates present a number of challenges in regards to their health
The International Commission on Radiological Protection (ICRP) has both encouraged “authorized bodies” to set diagnostic reference levels (DRLs) as dose optimization tools[4], consistent with regional, national or local area to which they apply and defined the concept of effective dose (E)[4], which has become an accepted method for estimating dose and associated risks in diagnostic radiology
It is noted that the neonatal intensive care units (NICU) of the UHB applied a low tube voltage technique with a high mAs setting, which will present a certain effect on increasing the patient dose
Summary
Sick and premature neonates present a number of challenges in regards to their health. In the neonatal intensive care units (NICU), neonates, and especially those born prematurely often suffer from serious medical complications, due to diseases in the respiratory and cardiovascular system. During their hospitalization in these units, most of them will require multiple chest and chest abdomen radiologic examinations, for the diagnosis, the follow-up and the treatments. Radiation risk relies mainly on the patient’s age; neonates are at highest risk for radiation induced malignancies[1,2] as a consequence of relatively long life expectancy which together with their radiosensitivity and potentially large number of radiographs performed during a short period of time. In Tunisia, the contribution of these examinations to the patient’s exposure is still largely unknown
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