The main purpose of this study was to investigate patient dose in the chest (PA/AP/LAT) and skull (PA/AP/LAT) X‐ray examinations, as frequent procedures. The study was performed in eight public hospitals of Khuzestan province, Iran. Patient dosimetry was conducted on 567 standard patient X‐ray examinations (males: 61.2%, female: 38.2%). Dosimetry protocol in this study was indirect method, according to the International Atomic Energy Agency (IAEA) Technical Reports series No. 457. Patients weighing 70±10 kg were considered as standard. In the indirect dosimetry approach, exposure parameters such as kVp, mAs, focal film distance (FFD), and tube outputs recorded during data acquisition were used for calculating incident air kerma on the patient's skin, entrance surface air kerma (ESAK) that is recommended by the IAEA as the most appropriate patient dosimetry quantity in simple radiographic examinations. This survey reveals significant variations in the radiological practice. Results showed that the parameters set by radiologic technologists change in a wide range: mAs varied from 2 to 80 for skull PA, 2 to 202 for chest LAT, and FFD varied from 50 to 180 for skull LAT projection. The study showed that patient doses in three chest projections exceed the IAEA and European Commission dose reference levels (EC DRLs) — 1.0, 1.12, and 2.20 mGy for chest PA, chest AP, and chest LAT, respectively. Results also showed that mean ESAKs of patients in skull projections were generally lower than the IAEA and EC DRLs, 1.5, 1.72, and 2.25 for skull LAT, skull AP, and skull PA, respectively. This study provides evidence that dose reduction in the simple X‐ray examinations is feasible by updating clinical audits and implementation of systematic quality assurance (QA) and quality control (QC) programs. The authors recommend that DRLs obtained in this study can be used as local DRLs in Khuzestan area and dose surveys must be performed in all provinces to establish national dose reference levels (NDRLs) in Iran.PACS numbers: 87.53.Bn, 87.57.uq, 87.59.B

Introduction: The main purpose of this study was to investigate patient dose in pelvic and abdomen x-ray examinations. This work also provided the LDRLs (local diagnostic reference levels) in Khuzestan region, southwest of Iran to help establish the NDRLs (national diagnostic reference levels). Methods: Patient doses were assessed from patient's anatomical data and exposure parameters based on the IAEA indirect dosimetry method. With regard to this method, exposure parameters such as tube output, kVp, mAs, FFD and patient anatomical data were used for calculating ESD (entrance skin dose) of patients. This study was conducted on 250 standard patients (50% men and 50% women) at eight high-patient-load imaging centers. Results: The results indicate that mean ESDs for the both pelvic and abdomen examinations were lower than the IAEA and EC reference levels, 2.3 and 3.7 mGy, respectively. Mean applied kVps were 67 and 70 and mean FFDs were 103 and 109, respectively. Tube loadings obtained in this study for pelvic examination were lower than all the corresponding values in the reviewed literature. Likewise, the average annual patient load across all hospitals were more than 37000 patients, i.e. more than 100 patients a day. Conclusions: The authors recommend that DRLs (diagnostic reference levels) obtained in this region, which are the first available data, can be used as local DRLs for pelvic and abdomen procedures. This work also provides that on-the-job training programs for staffs and close cross collaboration between physicists and physicians should be strongly considered.

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The main purpose of this study was to investigate dose rate emanating from patients treated with 131I to evaluate which of the theoretical formulas, inverse-square law (ISL) and International Atomic Energy Agency-International Commission on Radiological Protection (IAEA-ICRP) suggested equation, can provide a sufficiently close approximation of the measured dose rate. Measurements were performed based on the IAEA safety report No. 63 method at 0, 12, 24, and 48 h after administration of radioiodine at a distance of 1 m for 69 patients and for the rest of 67 patients, dose rate was measured at 2, 4, 24, and 48 h at a distance of 2 m. Results revealed that the ISL formula gained better approximation of measured dose rates than the IAEA-ICRP equation with the lesser error. The ISL formula is still more reliable than the novel method of dose calculation in the vicinity of patients. This finding reminded us the prime importance of distance as a radiation protection principle.