Patient dose audit of the most frequent radiographic examinations and the proposed local diagnostic reference levels in southwestern Nigeria: Imperative for dose optimisation

Abstract

Diagnostic reference levels (DRLs) is a veritable tool for dose optimisation and patient protection in diagnostic radiology. However, it is essential to have information on the local situation especially in a large hospital with several units or a cluster of healthcare centres within a geographical region with several X-ray units. In the present study, entrance surface doses (ESDs) were measured in twelve (12) healthcare centres consisting of 15 radiological units using thermoluminescent dosimeters (TLDs). Seven radiological procedures such as; chest PA, abdomen AP, pelvis AP, lumbar spine AP, skull AP, knee AP, and hand AP frequently carried out in Nigeria were included in the study, and their local diagnostic reference levels (LDRLs) were determined. The values of the determined LDRLs were compared with established NDRLs in UK, US, Slovenia, Italy and Brazil. The LDRLs determined in the two groups (healthcare centres) studied ranged from 1.78 to 3.01, 2.71 to 2.84, 2.11 to 3.79, 3.93 to 8.79, 1.06 to 1.73 and 1.10 to 1.44 mGy for chest PA, pelvis AP, lumbar spine AP, skull AP, knee AP and hand AP respectively. Large variations were found among the X-ray units studied even within the same centre. Entrance surface doses obtained in pelvis AP and lumbar spine AP in both GROUP A and were found to be lower than the NRPB-HPA 2010 review for UK, while in all other five examinations, value of the measured entrance surface dose (ESD) are higher than the doses reported in the UK review. The relative higher doses found in the study are attributable to higher tube load (mAs) used and indicative of the need for dose optimisation in Nigerian radiological practice.

Performance Characteristics of Radiographic equipment in Selected Healthcare Institutions in Southwest Nigeria

“…The X-ray outputs (mGy/mAs) were determined at a focus detector distance (FDD) of 100 cm with a tube potential setting of 80 kVp and tube loading of 10/15 mAs [17], [18].…”

Dose Audits of Patients Undergoing Some Common Radiographic Examinations in Selected Nigerian Hospitals

“…The Quality Control (QC) test for each machine was carried out using QC kit (NERO TM 6000m, manufactured by Victoreen, INC, Cleveland, Ohio, USA). The QC test was carried out by positioning the QC kit at the center of the beam axes at focus to image distance (FID) of 100cm (Jibiri & Olowookere, 2016). The QC tests carried out on each machine are: the kVp parameters (accuracy, reproducibility and consistency), the exposure time (including reproducibility and accuracy) and the output of the machines (including linearity coefficient and output reproducibility).…”

Qualitative Assessment of X-Ray Machines’ Mechanical Parameters at Some Selected Diagnostic Centres in Nigeria

“…Since the discovery of X-Ray in 1895 by Wilhelm Rontgen, medical imaging with X-Ray has become an indispensable healthcare delivery procedure in the diagnosis and treatment of diseases [1]. The major concern of clinicians in medical X-Ray imaging is how to obtain image quality that is consistent with clinical diagnosis of the disease at a minimum radiation dose to patients [2,3]. This is because; the medical use of ionizing radiation has the potential of significantly increasing the exposure of the population to ionizing radiation if the principles of radiation protection are compromised.…”