ABSTRAKDOSIS PASIEN PADA PEMERIKSAAN RUTIN SINAR-X RADIOLOGI DIAGNOSTIK. Teknik diagnosis untuk melihat kondisi fisik seorang pasien dengan menggunakan pesawat sinar-X merupakan teknik yang paling banyak digunakan di dunia. Berdasarkan Badan PBB untuk Efek Radiasi Atom (UNSCEAR), pajanan radiasi sinar-X pada pemeriksaan rutin radiologi diagnostik memberikan kontribusi terbesar bagi penerimaan dosis radiasi oleh penduduk dunia. Untuk kepentingan keselamatan pasien, Badan Tenaga Atom Internasional (IAEA) telah merekomendasikan penggunaan tingkat acuan diagnostik (DRL) agar dosis radiasi yang diterima pasien tersebut optimum sambil tetap mempertahankan kualitas citra film yang dihasilkan dari aplikasi ini. Dalam kaitan ini telah dilakukan studi tingkat dosis radiasi yang diterima oleh pasien dari aplikasi radiasi di bidang radiologi diagnostik. Hasil studi dibandingkan dengan tingkat acuan diagnostik yang berlaku di Indonesia. Studi dilakukan dengan melakukan pengukuran dosis permukaan masuk pada 130 orang pasien yang menjalani pemeriksaan thorax (AP/PA), thorax lat, abdomen, kepala AP/PA, kepala Lat, lumbo sacral AP, lumbo sacral Lat, ekstremitas, pelvis AP, cervical AP, cervical Lat, cervical oblique, clavicula dan thoracal lumbal di tiga rumah sakit di kota Makassar, Sukabumi, dan Pontianak. Hasil studi menunjukkan bahwa data dosis radiasi yang diterima pasien pada pemeriksaan thorax AP/PA, thorax lat, abdomen, kepala AP/PA, kepala lat, lumbosacral AP, lumbosacral lat dan pelvis AP menunjukkan nilai yang tidak melebihi nilai tingkat acuan diagnostik yang berlaku di Indonesia, dan dosis radiasi yang diterima pasien anak lebih rendah daripada dosis pasien dewasa. Perbandingan nilai dosis pasien yang diperoleh pada studi ini dan di Malaysia dengan hasil yang diperoleh dari beberapa negara maju juga memperlihatkan bahwa dosis pasien di negara berkembang relatif tidak berbeda dengan dosis pasien di negara-negara maju tersebut. ABSTRACTDOSES TO PATIENTS IN ROUTINE X-RAY EXAMINATIONS OF DIAGNOSTIC RADIOLOGY. Diagnostic technique to study physical condition of a patient using X-rays is the most common technique used in the world. According to the United Nations Scientific Committee on Effects of Atomic Radiation (UNSCEAR), radiation exposures in routine X-rays examination of diagnostic radiology contribute to the biggest portion of radiation doses received by world’s population. For the purposes of patient safety, diagnostic reference levels have been recommended by the International Atomic Energy Agency (IAEA) to be used in order to optimize the dose received by patient while maintaining quality of film image produced by these procedures. In this regard study on the determination of the level of radiation doses received by patient, has been carried out. Results of study are compared to the diagnostic reference levels for medical exposures applied in Indonesia. The study was performed by measuring entrance surface doses in 130 patients who underwent the X-ray examinations of thorax AP/PA, thorax lat, abdomen, skull AP/PA, skull Lat, lumbo sacral AP, lumbo sacral Lat, extremities, pelvis AP, cervical AP, cervical Lat, cervical oblique, clavicula and thoracal lumbal in three hospitals in the cities of Makassar, Sukabumi, dan Pontianak. The results show all data of patient doses from examinations of thorax AP/PA, thorax lat, abdomen, skull AP/PA, skull Lat, lumbo sacral AP, lumbo sacral Lat, extremities and pelvis APwere less than the levels applied in Indonesia and doses received by children were less than those by adult patients. Comparison of data obtained in this study and in Malaysia as developing countries with those from advanced countries also showed that they were relatively no difference between the two groups.
Interventional cardiology is a branch of cardiology that manages the catheter based treatment of structural heart illnesses. These minimally invasive procedures involve inserting catheters and other devices through superficial arterial and venous access sites. Due to increased reliability and advancing technology, the number and complexity of interventional cardiology procedures haves increased in recent years. The increasing complexity of the procedures, however, require longer fluoroscopic duration, leading to increased exposure time to ionizing radiation for the patient and also for the medical staff since they need to remain close to the patient throughout the procedure. This study attempts to investigate the occupational and patient doses during the course of several interventional cardiology procedures in Indonesia, i.e. CA, PCI, cathscan, PA, PTCA, TACE, PAC and peripheral vascular. Occupational doses were measured by using individually packed three chips of TLD-100 placed in over-and under-thyroid shield used by medical staff, over-and under-apron in waist position, inside a special 'eye-D' holder, and inside a ring holder, while patient doses were estimated by using individually packed three TLD-100 chips attached in the x-ray tube. All TLDs were calibrated in the Secondary Standard Dosimetry Laboratory (SSDL) Jakarta. The study was performed in three big hospitals in the cities of Jakarta, Yogyakarta and Semarang. The results show that PCI procedure was the most performed one during the course of this study and gave the highest radiation doses to the staff for all type of doses calculated and measured. The maximum effective doses, eye lens doses, extremity doses, thyroid doses and gonad/ovary doses were 0.098 mSv, 0.1967 mSv, 0.7604 mSv, 0.1760 mSv and 0.0990 mSv, respectively. In the case of patient doses, the mean value of DAP for PTCA procedure of 776.76 Gy cm 2 was the highest compared with those for other procedures. The results of measurement for occupational doses were in general similar to those reported by other authors, but not for patient doses that was found to be 4-5 times higher. Due to the involving of various parameters during the course of interventional cardiology procedures, it was difficult to establish a correlation between the doses received by medical staff and by the patients.
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