This study aimed to calculate patient radiation doses for adults during the seven most commonly performed conventional X-ray procedures, and to propose national diagnostic reference levels (DRLs). A representative sample of patients from 29 hospitals was included. The entrance surface air kerma (ESAK) was calculated by measuring X-ray tube output and the corresponding technical and exposure factors for each patient. Third-quartile values of the mean ESAK distributions were proposed as DRL values. The DRLs in mGy were as follows: 0.6 for chest postero–anterior (PA), 3.5 for skull AP, 1.7 for skull lateral (LAT), 2.7 for abdominal, 2.6 for pelvic AP, 3.7 for lumbar spine AP and 8 for lumbar spine LAT. Compared with literature, the maximum percentages increase were in chest PA (329%) and skull AP (187%). Since the suggested DRL for chest PA was higher than literature values, dose optimization and a review of its value is recommended.
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.
The diagnostic reference level (DRL) is a patient-exposure optimization tool used to evaluate and provide guidance for radiation doses in medical imaging. In the past few decades, there has been a global increase in the number of diagnostic imaging procedures, including nuclear medicine procedures, and consequently in patient radiation exposure. This increase has encouraged international and national health-care organizations to take action and keep up with such changes to meet the expectation of increasing use of ionizing radiation in medicine. Methods: DRLs in Kuwait were established by investigating the administered activity of radiopharmaceuticals and CT radiation doses in hybrid imaging systems. The DRLs were determined on the basis of the 75th percentile of radiopharmaceutical administered activity distribution as recommended by the International Commission on Radiological Protection. Results: The DRLs determined in Kuwait agree well with other published DRLs in Europe, Japan, Korea, Australia, and the United States. Conclusion: This study presents the establishment process and the results of the first national DRLs for nuclear medicine procedures in Kuwait as a way to optimize radiation exposure.
In this study, which is the first of its kind in the gulf region, eye doses of interventional cardiologists and nurses were measured using active dosimeters for left and right eyes, in 60 percutaneous coronary interventions in three main hospitals in Kuwait. The dose given in terms of H p (0.07) per procedure when ceiling suspended screens were used by main operators ranged from 18.5 to 30.3 µSv for the left eye and from 12.6 to 23.6 µSv for the right eye. Taking into account typical staff workload, the results show that the dose limit of 20 mSv/year to the eyes can be exceeded for interventional cardiologists in some situations, which demonstrates the need of using additional effective radiation protection tools, e.g. protective eye spectacles, in addition to the regular and proper use of ceiling suspended screens. With indications of increase in workload, the need for availability of a dedicated active dosimeter for the regular monitoring of eye doses is emphasized.
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