Estimation of entrance surface air kerma due to diagnostic X-ray examinations of adult patients in Uttarakhand, India and establishment of local diagnostic reference levels

Abstract

It is well established that diagnostic X-ray practices must be optimised to keep patient radiation dose as low as compatible with providing the diagnostic information required. For effective optimisation of diagnostic exposures, the International Commission on Radiological Protection (ICRP) introduced the concept of diagnostic reference levels (DRLs) in 1996. The present study aimed to carry out an extensive dose survey of diagnostic radiography installations in the Uttarakhand region of India to establish local DRL Values for the different diagnostic practices. During the survey, air kerma values were measured for 297 diagnostic X-ray machines installed at 270 medical centres in the region and the entrance surface air kerma (K ) was estimated for ten commonly performed radiographic projections. These included chest posterior-anterior (PA), cervical spine anterior-posterior (AP), skull PA, abdomen AP, KUB (kidney, ureter and bladder), lumbar spine AP, lumbar spine lateral (LAT), pelvis AP, thoracic spine AP, and thoracic spine LAT. Wide variations were observed in the estimated values of K for individual projections. The third quartile of the distribution of the median values of the estimated K for a given projection was calculated to establish local DRL Values. The majority of the acquired dose data were found to be comparable to or less than the proposed national and international DRLs. The local DRL Values reported in this study may be used to improve radiological practice by reducing patient doses during radiography examinations. The obtained data may also contribute to a national patient dose database for establishing future national DRLs.

Assessment of Patient’s Dose During Ap Pelvis Radiographic Examination in Selected Hospitals of Al Najaf City, Iraq

“…However, another similar two studies conducted in Nepal and Ghana to assess the AP pelvis patients' dose in 2016 and 2013 respectively [8,27] reveal that the ESD values were almost comparable to this study ESD except at two units in Ghana were the dose were extremely higher than this study and the international published levels [6,23]. Finally, a recent study conducted in India in 2017 [28] demonstrates that ESD for pelvis radiography was higher than the ones calculated in this study (e.g. average ESD 4.33 mGy).…”

Diagnostic Reference Levels for Common X-ray Procedures in Peru

“…The DRLs for intraoral dental radiographs differ but stay within the same range from the results obtained by Kim et al [17] in Korea, where the 75th percentile for an adult molar examination was 3.07 mSv. Likewise, the results obtained for general radiographic examinations vary from those obtained by Kiljunen et al [18] in Slovenia, Sonawane et al [20] in India, and Uniyal et al [21] in India. The first authors obtained a value of the 75th percentile of lumbar spine AP of 7.98 mSv and of 0.35 mSv for chest PA.…”

“…In the case of Sonawane et al [ 20 ], they obtained values ​​of lumbar spine AP of 8.39 mSv and of 0.68 mSv for chest PA. Finally, Uniyal et al [ 21 ] obtained values ​​of 8.55 mSv for lumbar spine AP and 0.43 mSv for chest PA. Moreover, DRLs also differ but were found on the same range when compared with Lithuania, whose reference diagnostic values ​​are 9 mSv for lumbar spine AP and 0.6 mSv for chest PA [ 22 ], Switzerland with values ​​of 8.7 mSv for lumbar spine AP and 0.2 mSv for chest PA [ 23 ], and the United Kingdom, whose DRLs are 5 mSv for lumbar spine AP and 0.15 mSv for chest PA [ 24 ].…”

Evaluation of Patient Radiation Doses in Skull Radiography

“…Satish et al, presented DRLs via dose survey of mixed type of X-ray machines. For skull PA, the percentage decrease of radiation dose is found to be 88% (Uniyal et al, 2017). Doses below DRLs indicates radiographic practice in acceptable limits, but dose audits are required to maintain ALARA.…”

“…Demographic information and technical parameters are presented in Table 1. review (Rana, 2018;Uniyal, 2017;. Table 3 presents the effective doses its comparison with mean doses of UK 2011.…”