In 2009-2014, dose surveys aimed to collect adult patient data and parameters of most common radiographic examinations were performed in six Russian regions. Typical patient doses were estimated for the selected examinations both in entrance surface dose and in effective dose. 75%-percentiles of typical patient effective dose distributions were proposed as preliminary regional diagnostic reference levels (DRLs) for radiography. Differences between the 75%-percentiles of regional typical patient dose distributions did not exceed 30-50% for the examinations with standardized clinical protocols (skull, chest and thoracic spine) and a factor of 1.5 for other examinations. Two different approaches for establishing national DRLs were evaluated: as a 75%-percentile of a pooled regional sample of patient typical doses (pooled method) and as a median of 75%-percentiles of regional typical patient dose distributions (median method). Differences between pooled and median methods for effective dose did not exceed 20%. It was proposed to establish Russian national DRLs in effective dose using a pooled method. In addition, the local authorities were granted an opportunity to establish regional DRLs if the local radiological practice and typical patient dose distributions are significantly different.
Computed tomography (CT) is often a justified diagnostic tool, but is also associated with high exposure of the patients. Due to the rapid increase in the number of CT units and thus the availability of CT examinations in Russia, there is a growing need for optimisation within this field. In order to develop proper optimisation procedures for CT, the two regions St. Petersburg and Belgorod of Russia were chosen, representing an urban and a rural region, respectively. In 2014, a survey was conducted of the parameters applied in CT examinations in these regions, and the results show that the highest effective doses were observed for investigations of abdomen, reaching up to 137 mSv, and pelvic CT examinations, reaching up to 58 mSv, both with contrast agents. The dose distributions were approximately log-normal, and for the majority of the examinations, the 75th percentiles of the CT dose distributions in the Belgorod region were higher than observed in St. Petersburg. The aim of the current project is primarily to define and implement diagnostic reference levels as a part of the process of optimisation of CT examinations in Russia.
The number and specification of radionuclide examinations, administrated activity and effective doses were collected during 2011-13 for 4944 paediatric patients from 10 nuclear medicine (NM) departments of some Russian regions. The kidney examinations account for about 70 % of paediatric NM examinations in general hospitals. Diagnostics of all other organs contribute from 2 to 8 % each in the total number of paediatric examinations. Administrated activities of radiopharmaceuticals are approximately proportional to the child's age, and variations between different hospitals usually are within the factor of 3-4 and for some types of examination up to 10. The range of the effective dose due to paediatric NM examinations is roughly estimated as 2-6 mSv per examination, approximately the same as in adults. Some examinations (heart, thyroid, whole body) result in doses of younger children that are 2-3 times higher than the doses of adults. Effective doses in paediatric positron emission tomography (PET) diagnostics are in the range of 4-10 mSv per examination and are higher compared with the dose of adult patients. The application of combined radiodiagnostic technologies (single photon emission computer tomography with roentghen computer tomography [SPECT/CT] or PET with roetghen computer tomography [PET/CT]) increases the effective dose of patients by the factor of 1.5-2 for the skeleton or whole body examinations.
служба по надзору в сфере защиты прав потребителей и благополучия человека, Москва, Россия 3 Санкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека, Санкт-Петербург, Россия 4 Управление Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека по городу Санкт-Петербургу, Санкт-Петербург, Россия 5 Управление Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека по Ленинградской области,
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