National reference doses for common radiographic, fluoroscopic and dental X-ray examinations in the UK

Abstract

The National Patient Dose Database (NPDD) is maintained by the Radiation Protection Division of the Health Protection Agency. The latest review of the database analysed the data collected from 316 hospitals over a 5-year period to the end of 2005. The information supplied amounted to a total of 23 000 entrance surface dose measurements and 57 000 dose-area product measurements for single radiographs, and 208 000 dose-area product measurements along with 187 000 fluoroscopy times for diagnostic examinations or interventional procedures. In addition, patient dose data for dental X-ray examinations were included for the first time in the series of 5-yearly reviews. This article presents a summary of a key output from the NPDD - national reference doses. These are based on the third quartile values of the dose distributions for 30 types of diagnostic X-ray examination and 8 types of interventional procedure on adults, and for 4 types of X-ray examination on children. The reference doses are approximately 16% lower than the corresponding values in the previous (2000) review, and are typically less than half the values of the original UK national reference doses that were derived from a survey in the mid-1980s. This commentary suggests that two of the national reference doses from the 2000 review be retained as diagnostic reference levels because the older sample size was larger than for the 2005 review. No clear evidence could be found for the use of digital imaging equipment having a significant effect on dose.

Local reference dose evaluation in conventional radiography examinations in Iran

“…DRLs for cervical spine AP and LAT using DAP measurements were not reported in NRPB and other studies 7 , 27 Table 6 shows that the first DRLs for these are 0.16 and 0.25 Gy.cm 2 , respectively.…”

Fluoroscopy for transpedicular screw placement in scoliosis: to what extent can radiation exposure be reduced by the freehand technique?

“…DAP values are related to fluoroscopy time, fluoroscopy output and filtration, diameter of image intensifier and kVp-mA values. Measured values may be compared to reference values reported for certain procedures (7). In adolescent idiopathic scoliosis, Schaefer et al (15) reported mean DAP values of 94.9 cGy.cm 2 for conventional AP full spine radiographs and 7.8 cGy.cm 2 for the fluoroscopic scanning method.…”

Patient radiation exposure during general fluoroscopy examinations

“…The ${\mathrm{normalK}}_{\mathrm{a},\mathrm{r}}$ in children were smaller than those for adults due to the automatic selection of fluoroscopy technique triggered by the smaller patient size. The fluoroscopy examinations were performed with longer time and higher KAP, resulting in large effective doses (Table 3) that were also broad with respect to the measured values as compared to the available values in the literature 2 , 9 , 10 , 11 , 12 , 13 , 14 , 15 . The IDRLs for the ${\mathrm{normalK}}_{\mathrm{a},\mathrm{r}}$, KAP, and fluoroscopy time, especially in children, were not available in the cited literature for comparison.…”

“…These quality assurance challenges are exacerbated by emerging health needs and lack of adequate resources coupled with the ballooning population. This study aimed to determine the radiation dose to patients, establish the necessary optimization strategies for fluoroscopy procedures, and compare the findings with the international DRLs 2 , 9 , 11 , 12 , 13 , 14 , 15 …”