Common Diagnostic X-ray Examinations Research Articles

Evaluation of the Entrance Surface Doses (ESD) for common diagnostic X-ray examinations

ObjectiveThe purpose of this study was to assess the Entrance Skin Dose (ESD) in patients undergoing multiple types of radiographic examinations across three hospitals in Saudi Arabia. MethodsThe patient ESD was estimated directly using optically stimulated luminesces (OSL) and indirectly using a survey meter and calculations for 100 adult patients undergoing common diagnostic X-ray examinations, including a posterior anterior chest, posterior anterior hand, anterior posterior foot, and anterior posterior knee examinations, in three hospitals in Saudi Arabia. Comparative analysis with national and international reference values was conducted. ResultsOur analyses revealed considerable heterogeneity in X-ray exposure parameters among the hospitals. The mean ESD values for the chest examination were 0.28 ± 0.13 mGy for the direct method and 0.19 ± 0.11 mGy for the indirect method. Hand examination using the direct method resulted in a mean ESD of 0.42 ± 0.15 mGy, while the indirect method yielded 0.23 ± 0.06 mGy. Remarkably, the ESD values in most cases exceeded national and international guidelines, with the knee examination ESD using the direct and indirect methods showing an alarming value of 1.54 ± 0.31 mGy and 1.18 ± 0.21 mGy, respectively. The correlation between direct ESD, indirect ESD showed a strong positive correlation exists between direct ESD and Indirect ESD (r = 0.8, p < 0.001). ConclusionThe study highlights the urgent need for standardized protocols and quality control measures across radiographic facilities in Saudi Arabia. The elevated ESD values signify a critical issue that requires immediate attention to minimize patient radiation exposure while maintaining diagnostic image quality. Quality control tests and adjustments in examination parameters are strongly advised.

DETERMINATION OF ENTRANCE SURFACE DOSE FOR THREE COMMON PLANAR DIAGNOSTIC X-RAY EXAMINATIONS.

Patient dose during diagnostic radiography procedures primarily depends on the entrance surface dose (ESD) and the exposure area. The purpose of this study was to determine ESD for five common diagnostic X-ray examinations using dose area product and X-ray tube output. The ESDs were estimated in a sample of 340 patients using normalised X-ray output from Philips-PrimaryDiagnost digital X-ray machine equipped with digital flat panel scintillator detector. The resultant mean ESDs for chest postero-anterior/lateral, lumbar spine antero-posterior (AP)/lateral and abdomen AP were 0.49, 2.00, 5.74, 12.79 and 4.62mGy, respectively. The mean and third quartile ESD values of this study were significantly higher than the values found in the literature. This can be attributed to the lower tube potential (kVp) values and the higher tube current-time products (mAs). The methodology used here is a better option for low-resources countries for routine dose monitoring.

Patient-Based Dose Audit for Common Radiographic Examinations With Digital Radiology Systems: A Retrospective Cross-Sectional Study.

This study aims to audit radiation doses of adult patients who underwent common diagnostic X-ray examinations and compare dose area product (DAP) values with the established International Diagnostic Reference Level (IDRLs). Retrospective cross-sectional records of 339-patients who underwent 699-radiographic examinations between October 2018 and March 2019 were obtained. Patient-related factors, exposure, and DAP data were recorded for the six most common examinations. The mean and 75th percentile of DAPs were recorded and compared to IDRLs values. The 75th percentiles of the locally measured DAPs were below IDRLs for all examinations except for lateral lumbar, AP, and lateral thoracic spine, in which DAP-75th-percentile exceeded all IDRLs by up to 40.7%, 2.8%, 365.5%, respectively. Considering the type of detector used, the mean of the locally measured DAPs significantly exceeded the UK DRLs for the lateral thoracic spine and lateral lumbar spine. Locally measured DAP values were below the IDRLs except for thoracic and lumbar spine projections, which significantly exceeded.

Local Diagnostic Reference Levels for Some Common Diagnostic X-Ray Examinations In Sabzevar County of Iran

Introduction: Diagnostic reference level (DRL) is a useful tool for the promotion of optimization. The national DRLs (NDRLs) are useful, brief, and robust guidelines for optimizing radiation protection in a country. The aim of this study was to extract the local DRLs (LDRLs) for some common radiologic examination in Sabzevar county. Materials and Methods: There are eight radiology departments in Sabzevar County, Iran. The entrance skin dose (ESD) distributions were determined by use of thermoluminescence dosimeter (TLD) chips for 10 standard projections (i.e., anterioposterior [AP] abdomen, AP and posteroanterior [PA] chest, AP and lateral [LAT] lumbar spine, AP pelvis, cervical AP, cervical LAT, as well as AP and LAT skull). The third quartiles of the measured ESDs were compared with the previously published data. Results: In the present study, the third quartile of the measured ESDs for the patients undergoing specific examination were selected as LDRLs. The calculated LDRLs for the chest PA, chest AP, lumbar spine PA, lumbar spine LAT, pelvis AP, abdomen AP, cervical AP, cervical LAT, skull PA, and skull LAT were 0.54, 0.64, 1.99, 3.83, 1.47, 2.15, 0.54, 0.78, 1.22, and 1.01 mGy, respectively. Conclusion: Our results were compared with the DRLs reported in Iran, UK, and Japan as well as those reported by the National Radiological Protection Board (NPRB) for the UK. The ESDs obtained in this study for the chest PA, cervical AP, cervical LAT, AP and LAT skull, abdomen AP, pelvis AP, lumbar PA, and lumbar LAT examinations did not exceed the DRL values reported by NPRB.

Patients doses Estimation in Common Diagnostic X-Ray Examinations and Local DRLs Determination for All Types of Patients

Patients doses Estimation in Common Diagnostic X-Ray Examinations and Local DRLs Determination for All Types of Patients

Measurement of Entrance Skin Dose and Calculation of Effective Dose for Common Diagnostic X-Ray Examinations in Kashan, Iran.

The knowledge of the radiation dose received by the patient during the radiological examination is essential to prevent risks of exposures. The aim of this work is to study patient doses for common diagnostic radiographic examinations in hospitals affiliated to Kashan University of Medical sciences, Iran. The results of this survey are compared with those published by some national and international values. Entrance surface dose (ESD) was measured based on the exposure parameters used for the actual examination and effective dose (ED) was calculated by use of conversion coefficients calculated by Monte Carlo methods. The mean entrance surface dose and effective dose for examinations of the chest (PA, Lat), abdomen (AP), pelvis (AP), lumbar spine (AP, Lat) and skull (AP, Lat) are 0.37, 0.99, 2.01, 1.76, 2.18, 5.36, 1.39 and 1.01 mGy, and 0.04, 0.1, 0.28, 0,28, 0.23, 0.13, 0.01 and 0.01 mSv, respectively. The ESDs and EDs reported in this study, except for examinations of the chest, are generally lower than comparable reference dose values published in the literature. On the basis of the results obtained in this study can conclude that use of newer equipment and use of the proper radiological parameter can significantly reduce the absorbed dose. It is recommended that radiological parameter in chest examinations be revised.

A Survey of Radiation Exposure Techniques Factors Used for Common Diagnostics X- Ray Examinations in Akwa Ibom State, Nigeria

The dose of radiation emitted by an X-ray source and delivered on a target depends on the source tube peak potential (kVp), the current time (mAs) and the source to film distance (FFD). There could be an harmful health effect on the patient if these exposure technique factors are not appropriately selected by the operators of these sources. Therefore the aim of this study is to survey the choice of these technique factors in X-ray departments in Akwa Ibom State, Nigeria, while undertaking some common diagnostic X-ray examinations. The common and mostly requested examinations considered were, Chest (PA), Skull (AP), Pelvis (AP) and Abdomen (AP). A total of 48 personnel, 952 adult volunteers in X-ray departments in nine Hospitals took part in the survey. The adults were age between 20-75 yrs and body weight 70 ± 13kg. Variations in the technique factors selected for the different examination were observed when compared with the values in CEC guidelines on quality criteria. The mean tube potential of 125 kVp selected for chest examination in this study is low compared to 180 kVp in the CEC. The mean mAs varies while some departments employed constant mAs for all examination and all patients not taking into account the body thickness of the patient. In skull and pelvis examination, some departments used lower kVps while some selected tube potentials within the CEC range of 70-85 kVp and 75-90 kVp respectively the mean FFD (162.0 cm) for chest in this study was within the CEC recommended value of 180.0 cm while low values of FFD were used in other examinations. Human and equipment factors were identified as possible reasons for the variations. The replacement of X-ray machines of more than 10 years, development of adequate and functional quality assurance programme for the facilities and retraining of the personnel are recommended as a panacea to minimize these variations.

Estimation of adult patient doses for common diagnostic X-ray examinations in Wad-madani, Sudan: derivation of local diagnostic reference levels

The objectives of this study were to estimate patient dose in some common diagnostic X-ray examinations. Radiation doses were estimated for 307 patients in six public hospitals comprising 7 X-ray units in Wad-madani, Sudan. Entrance surface air kerma (ESAK) was estimated in a three step protocol: First, X-ray unit output Y(d) was measured at a distance, d for different peak tube voltages and tube loadings (mAs). Next, incident air kerma (Ki) was calculated from Y(d) using inverse square law combined with patient exposure factors. ESAK was calculated from Ki using backscatter factor, B. Mean ESAK values are comparable to those reported in other countries and are below reference dose levels. The estimated mean ESAK values are: 0.3, 2.2, 2.2, 2.9, 2.8, 3.1, and 7.5 mGy for chest PA, Skull AP/PA, Skull LAT, Abdomen, Pelvis AP, Lumbar Spine AP and Lumbar Spine LAT examinations, respectively. The results are used for dose optimization, and to propose local diagnostic reference levels.

Radiation Exposure of Patients Undergoing Common Diagnostic X-Ray Examinations in Some Major Hospitals in Visakhapatnam, India

Background: Everyone alive in this world is constantly being exposed to ionizing radiation and about 18% exposure is due to man-made source. Recent developments in medical imaging have led to rapid increases in a number of high dose x-ray examinations performed with significant consequences for individual patient doses and for collective dose to the population as a whole. It is therefore important in each country to make regular assessments of the magnitude of these large doses. Objectives: To calculate collective dose of the population as a result of radiation dose from diagnostic x-rays, there by to estimate the annual effective dose per patients which would be reduced by the use of rare earth intensifying screen. Materials and Methods: Data on the number of diagnostic procedures using x-ray examination in year 2010 in one governmental and four private Hospitals by body site were collected in Visakhapatnam. Typical effective doses for those examinations making major contributions to collective was calculated according to the European Guidance on Estimating Population Doses from Medical X-rays .The annual collective effective doses from x-ray diagnostics were obtained by multiplication of the estimated effective doses per examination type with the corresponding annual frequency and summation over all types of examination. The results were then collected and entered into a database for analysis. Results: A total of 46350 (1.2 exams/patient) medical examination were collected in five hospitals in year 2010. The total collective dose to all patients from diagnostic plain x-rays, IVU and Barium studies was 47.3 man.Sv, this result in an annual effective dose per patient of 1.23 mSv. Lumbar spine and Barium follow accounted 13.65 man. Sv (28.88%) and 13.08 man.Sv (27.67%) of the total annual collective dose which results in 15.5% and 2.8% of exposures respectively. Conclusion: Although the use of ionizing radiation for diagnostic medical procedures is an acceptable part of modern medicine, there is also the potential for inappropriate use and unnecessary radiation dose to the patient, so the request of high dose procedures must be justified.

An evaluation of entrance and surface doses for some common diagnostic x-ray examinations in two Nigerian University Teaching Hospitals

An evaluation of entrance and surface doses for some common diagnostic x-ray examinations in two Nigerian University Teaching Hospitals

An evaluation of entrance and surface doses for some common diagnostic X-ray examinations in two Nigerian University Teaching Hospitals

An evaluation of entrance and surface doses for some common diagnostic X-ray examinations in two Nigerian University Teaching Hospitals

Estimation of adult patient doses for common diagnostic X-ray examinations in Rio de Janeiro, Brazil

DoseCal software has been used to evaluate the Entrance Surface Dose (ESD) and Effective Dose (ED) of adult patients undergoing abdomen, cervical spine, chest, lumbar spine and skull diagnostic X-ray examinations in AP, PA and LAT projections. The survey was carried out in nine hospitals in Rio de Janeiro state with a total of 1917 radiographs. The mean values of ESD (mGy) and ED (mSv) were recorded. Although the results obtained are below the international diagnostic reference levels, they present large variations within and between hospitals which reflects the disparity of radiographic techniques used in the examinations. The results were compared with the European Community Reference Levels. Even though in Brazil there are specific legislations on radiation protection and implementation of Quality Assurance Programs (QAPs) in all medical institutions, there is still a need for personnel training and national guidance on good practice for optimization of patients' doses.

Local diagnostic reference levels for some common diagnostic X-ray examinations in Tehran county of Iran

Various researchers who have carried out national and international surveys have reported wide variations in patient dose arising from specific X-ray examinations. This study was carried out as a part of a comprehensive project to establish national diagnostic reference level (NDRL), for the first time, in Iran. Seven most common X-ray examinations in 11 projections were included. Thermo luminescence dosimeters (TLD-100) were used to measure entrance surface doses (ESDs). The study group consisted of 535 patients who were referred for X-ray examinations to 12 randomly selected public hospitals in Tehran County. Minimum, median, mean, maximum, first and third quartile values of ESDs are reported. Our results are evident that mean dose values of patients undertaking a specific examination are widely different in various hospitals. Wide dose differences may emerge from complex causes, but in general, low peak kilovoltage and high milli Amperes are associated with higher doses. The results of this work together with further data expected to emerge from the work in progress will provide a useful base to establish Iran's DRLs.

NORMALIZED ORGAN DOSES AND EFFECTIVE DOSES TO A REFERENCE INDIAN ADULT MALE IN CONVENTIONAL MEDICAL DIAGNOSTIC X-RAY EXAMINATIONS

This work discusses the dose computations of 80 kV diagnostic x-rays made on a mathematical phantom representing an average Indian adult, since it is felt that results based on MIRD adult phantom calculations are not strictly appropriate for the population in India. Normalized organ equivalent doses and effective doses for an Indian adult male have been estimated. Normalization is done with respect to the entrance skin dose of the patient. Twenty common diagnostic x-ray examinations have been considered in this study and the doses are presented. This study would enable estimation of radiation induced detriment to the patient subpopulation in India. Since the external dimensions of the phantom are nearly the same as that of 15-y-old NRPB pediatric phantom, our results are also compared with those of latter and the agreement was found to be satisfactory.

Estimation of patient doses for common diagnostic X-ray examinations in Latvian hospitals, analysis of radiographic techniques and comparison with European guidelines

This article deals with the estimation of doses received by patients undergoing radiological examinations in order to establish dose reference levels (DRLs) in Latvia. Several large hospitals, small hospitals and private practices were selected for patient dose measurements. The measurements were carried out using calibrated thermoluminiscence dosemeters attached to the patient's skin. Exposure parameters and patient's data were recorded. The entrance surface doses (ESDs) to patients undergoing several common X-ray examinations (chest AP/PA, chest LAT, lumbar spine AP/PA, lumbar spine LAT and pelvis) were measured. Data concerning the kV(p) settings, used type of films, focus-film distance and the ESD values were analysed and compared with those recommended by the European Community (EC). Among the different hospitals and private practices, discrepancies in the patient doses and techniques used for the examination were found, where the doses exceeded the EC recommended values owing to a very low kV(p) and a very low sensitivity of the screen film combinations used.

Reference dose levels for patients undergoing common diagnostic X-ray examinations in Irish hospitals.

Wide variations in patient dose for the same type of X-ray examination have been evident from various international dose surveys. Reference dose levels provide a framework to reduce this variability and aid in the optimization of radiation protection. The aim of this study was to establish, for the first time, a baseline for national reference dose levels in Ireland for four of the most common X-ray examinations: chest, abdomen, pelvis and lumbar spine. Measurements of entrance surface dose using thermoluminescent dosemeters (TLDs) for these four X-ray examinations were performed on 10 patients in each of 16 randomly selected hospitals. This represented 42% of Irish hospitals applicable to this study. Results have shown wide variation of mean hospital doses, from a factor of 3 for an anteroposterior lumbar spine to a factor of 23 for the chest X-ray. The difference between maximum and minimum individual patient dose values varied up to a factor of 75. Reasons for these dose variations were complex but, in general, low tube potential, high mAs and low filtration were associated with high-dose hospitals. This study also demonstrated lower reference dose levels of up to 40% when compared with those established by the UK and the Commission of the European Communities for four out of six projections. Only the chest X-ray exhibited a similar reference level to those established elsewhere. This emphasizes the importance of each country establishing its own reference dose levels that are appropriate to their own radiographic techniques and practices in order to optimize patient protection.