Evaluation of patient radiation doses using DAP meter in diagnostic radiology procedures in Birjand, Iran

Abstract

Background The concept of diagnostic reference level (DRL) is considered a regular method to optimize radiation protection in diagnostic imaging system. The objective of implementing a reference level for dose is to produce high-quality images by applying a minimum dose of radiation based on the As Low As Reasonably Achievable (ALARA) principle. Therefore, this study aimed to evaluate the status of radiation protection in diagnostic radiology wards of educational hospitals affiliated with Birjand University of Medical Sciences. Methods This study was performed during a period of 11-months in the radiology center of the teaching hospital of Birjand University of Medical Sciences. The studied population included 477 patients who were referred to as clinically indicated x-ray radiography. In order to calculate local DRLs, dose area product (DAP) was measured by a DAP-meter (KERMAX-plus SPD, model 120–131 HS) for 11 devices at educational hospitals affiliated with Birjand University of Medical Sciences. The local DRL values was calculated as 75% of the mean DAP distribution for a specific patient trial at each center. Results DAP for Chest PA examination was gained to be in the range from 0.12 Gy.cm2 to 0.42 Gy.cm2 with an average value of 0.23 Gy.cm2 which is above the value of the reference level (0.12 Gy.cm2) for Chest PA. For Chest lateral the observed DAP was found to be in the range from 0.18 Gy.cm2 to 1.48 Gy.cm2 with an average value of 0.65 Gy.cm2 and are therefore twice the reference value (0.3 Gy.cm2). The higher DRL values (average = 2.73) are for lumbar spine lateral radiography. It is observed that the DRL values of chest PA, abdomen AP and Lumbar spine AP are much lower with the earlier studies. Conclusions The DRLs helps in understanding the current practices in radiographic examinations. Comparison with other hospitals, the scope of dose optimization and ultimately patient dose reduction in hospitals affiliated with Birjand University of Medical Sciences needs further investigation.

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“…This allows medical professionals to visualize bones and internal organs, detect abnormalities or injuries, and diagnose. X‐ray radiography is a widely used and versatile diagnostic tool 11 . Still, it does expose patients to small amounts of ionizing radiation, so its use should be carefully considered and justified based on medical necessity.…”

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“…The kerma-area product (P KA ), recommended by the International Commission for Radiological Protection (ICRP), is increasingly used for DRL establishment in numerous countries [14,20]. P KA for a particular examination can vary by changing the exposure parameters, altering the field size, or both, and reflecting the total amount of radiation used, facilitating the estimation of organ doses, effective doses, and the total energy deposited in the patient [21,22]. Importantly, it is, therefore, directly related to the total patient stochastic risks [21].…”