Determination of diagnostic reference levels in general radiography in Latin America

Blanco, Susana; Mora, Patricia; Almonte, Narkiss; Benavente, Tony; Benson, Nadja; Blanco, Daniel; Cárdenas, Juan Camilo; Gómez, Yolanda Défaz; Edding, Oscar; Escobar, Carolina; Fonseca, Maria de Jesus Mendes da; Gamarra, Mirta; Aguilar, Juan García; Khoury, Helen J.; Quintero, Ana Rosa; Zuniga, Norma Roas; Zaire, Edgar; Nader, Alejandro

doi:10.1093/rpd/nct069

Cited by 11 publications

(4 citation statements)

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“…In Peru, law 28028 [ 7 ], with its technical standard IR 003-2013, stipulates that the representative doses for patients must be determined for different radiographic procedures and that X-ray examinations must comply with the principles of justification, and optimization [ 8 ]. However, research in Peru for the establishment of DRLs is limited [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Reference Levels for Common X-ray Procedures in Peru

Bonifaz¹,

Rodriguez²,

Esparza³

2021

Cureus

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Diagnostic reference levels (DRLs) for X-ray procedures have been established in many countries since 1996. In Peru, data from the literature are used as guidelines as DRLs research is limited. The objective of this study is to analyze the parameters and variables which are used in radiological techniques such as kV, mAs, and type of machine (conventional or digital); study the geographical distribution of radiological X-ray machines, and establish DRLs in Peru. Two radiological procedures were considered, general X-rays (fixed and mobile) and intraoral X-rays (fixed, mobile, and portable). An Unfors RaySafe Xi detector (Unfors RaySafe AB, Billdal, Sweden) was used; air kerma was measured at a source to image distance that varied depending on the procedure, and the entrance skin dose was subsequently calculated using the Arcal XLIX formalism. The data were collected over a period of three years (2015)(2016)(2017). Only results from the last evaluation during this period were taken into consideration for each X-ray machine. DRLs were calculated at 0.21 mSv, and 0.25 mSv for posterior-anterior chest examinations in conventional and digital machines, respectively; 4.39 mSv and 6.01 mSv for conventional and digital antero-posterior lumbar spine examinations, respectively; and at 4.21 mSv for the dental intraoral procedure. The largest amount of X-ray machines is concentrated in the city of Lima. These results reflect the standard of practice in Peru.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Reference Levels for Common X-ray Procedures in Peru

Bonifaz¹,

Rodriguez²,

Esparza³

2021

Cureus

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“…The International Commission on Radiological Protection (ICRP), the International Atomic Energy Agency (IAEA), and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) recommend establishing guidance levels or diagnostic reference levels (DRLs), which are used in medical imaging with ionizing radiation, including roentgenography, computed tomography, and scintigraphy, to indicate whether the patient dose and administered activity (amount of radioactive material) are unusually high or low for a given procedure [ 6 ] [ 7 ]. DRL settings in each region are now spreading worldwide [ 8 ] [ 9 ] [ 10 ] [ 11 ]. However, DRLs for specific endoscopy procedures remain limited and are briefly described for ERCP in only the European Commission [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

et al. 2018

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IntroductionVarious endoscopic procedures under fluoroscopic guidance are being rapidly adopted, and radiation exposure is considered to be increasing. However, there is little concern about this issue in gastroenterology practice. This study aims to evaluate the actual radiation exposure dose (RD) during endoscopic retrograde cholangiopancreatography (ERCP) and the factors affecting the RD.MethodsIn this retrospective, single-center cohort study of 1157 consecutive patients who underwent ERCP between October 2012 and February 2017, we analyzed the influences of patient characteristics, procedure time (min), total fluoroscopy time (min), type of processing engine, experience of the endoscopist, and type of disease on the total RD (mGy).ResultsThe median procedure times were 28 min for common bile duct stones (CBDS), 25 min for distal malignant biliary obstruction (MBO), and 30 min for proximal MBO. Similarly, the median fluoroscopy times were 10.3, 8.8, and 13.4 min, and the median RDs were 167, 123, and 242 mGy, respectively. Proximal MBO required significantly longer procedure time and fluoroscopy time and resulted in greater RD than distal MBO (P = 0.0006, <0.0001, <0.0001) and CBDS (P = 0.015, <0.0001, <0.0001). Multiple linear regression showed that distal MBO and a novel processing engine negatively correlate with RD (P = 0.04, <0.0001) and that proximal MBO positively correlates with RD (P = 0.0001).DiscussionProcedure time and fluoroscopy time were significantly longer for proximal MBO than for CBDS and distal MBO. The type of disease and processing engine significantly influenced the RD during ERCP.

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“…J. Odontostomat., 15(1):196-203, 2021. Resultado de la prueba de control de calidad Sin perjuicio de lo anterior, cabe destacar algunos esfuerzos de parte de grupos de investigación nacionales, quienes han realizado estudios tendientes a crear conciencia a través del establecimiento de NRD en especialidades como la radiología intervencionista, mamografía y radiología general (Blanco et al, 2013;Nocetti & Leyton, 2014;Leyton et al, 2015). No obstante, la radiología dental no ha sido considerada en esta clase de estudios, de modo que los resultados obtenidos en el presente trabajo, constituyen el primer esfuerzo para establecer un NRD a nivel local en nuestro país, en radiología dental periapical, para las proyecciones de Incisivo y Molar maxilar, utilizando DTL y un maniquí antropomorfo.…”

Section: Discussionunclassified