Reference doses and quality in medical imaging.

Faulkner, K.; Corbett, R H

doi:10.1259/bjr.71.850.10211057

Cited by 15 publications

(7 citation statements)

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“…up to a factor of 100 for the same X-ray examination. [1112] A study carried out in the Irish hospitals has shown that the measured ESD values for individual patients varied up to a factor of 75 for the Lumbar spine AP examination. [13] In view of this, international organizations have recommended the use of DRLs in diagnostic radiology.…”

Section: Introductionmentioning

confidence: 99%

Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system

Sharma¹,

Sharma²,

Pawar³

et al. 2015

J Med Phys

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The screen-film system is replaced by computed radiography system for recording the images of the patients during X-ray radiography examinations. The change in imaging system requires the re-establishment of the institutional diagnostic reference levels (DRLs) for different types of X-ray examinations conducted at the hospital. For this purpose, patient specific parameters [age, height, weight, body mass index (BMI), object to image distance (OID)] and machine specific parameters (kVp, mAs, distance and field sizes) of 1875 patients during 21 different types of X-ray examinations were recorded for estimating the entrance skin dose (ESD). The ESD for each of these patients were estimated using measured X-ray beam output and the standard value of the back scatter factor. Five number summary was calculated for all the data for their presentation in the Box-Whisker plot, which provides the statistical distribution of the data. The data collected indicates that majorly performed examinations are cervical spine AP, Chest PA and Knee Lat with percentage contributions of 16.05, 16 and 8.27% respectively. The lowest contribution comes from Hip Lat which is about 1.01%. The ratio of measured ESD (maximum to minimum) for these examinations is found to be highest for the cervical spine AP with a value of 50 followed by Thoracic spine AP of 32.36. The ESD ratio for Chest PA, Knee Lat and Lumbar Spine AP are 30.75, 30.4 and 30.2 respectively. The lowest ESD ratio is for Hip Lat which is 2.68. The third quartile values of ESDs are established as the institutional DRLs. The ESD values obtained for 21 different X-ray projections are either comparable or lesser than the reported national/international values.

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Section: Introductionmentioning

confidence: 99%

Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system

Sharma¹,

Sharma²,

Pawar³

et al. 2015

J Med Phys

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“…In view of these wide variations in patient dose levels for the same X-ray examination, e.g. up to a factor of 100 [6,7], the International Commission on Radiological Protection (ICRP) has recommended the use of reference dose levels (RDLs) in diagnostic radiology [8]. It has also proposed that RDLs should be the result of optimization in radiation protection and should be used as an aid to keeping doses as low as reasonably achievable [7,9,10].…”

mentioning

confidence: 99%

“…up to a factor of 100 [6,7], the International Commission on Radiological Protection (ICRP) has recommended the use of reference dose levels (RDLs) in diagnostic radiology [8]. It has also proposed that RDLs should be the result of optimization in radiation protection and should be used as an aid to keeping doses as low as reasonably achievable [7,9,10]. Diagnostic reference dose levels have been de®ned in European legislation [11] as:``dose levels in medical radiodiagnostic practices or, in the case of radio-pharmaceuticals, levels of activity, for typical examinations for groups of standard-sized patients or standard phantoms for broadly de®ned types of equipment''.…”

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confidence: 99%

Reference dose levels for patients undergoing common diagnostic X-ray examinations in Irish hospitals.

Johnston¹,

Brennan²

2000

The British Journal of Radiology

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Wide variations in patient dose for the same type of X-ray examination have been evident from various international dose surveys. Reference dose levels provide a framework to reduce this variability and aid in the optimization of radiation protection. The aim of this study was to establish, for the first time, a baseline for national reference dose levels in Ireland for four of the most common X-ray examinations: chest, abdomen, pelvis and lumbar spine. Measurements of entrance surface dose using thermoluminescent dosemeters (TLDs) for these four X-ray examinations were performed on 10 patients in each of 16 randomly selected hospitals. This represented 42% of Irish hospitals applicable to this study. Results have shown wide variation of mean hospital doses, from a factor of 3 for an anteroposterior lumbar spine to a factor of 23 for the chest X-ray. The difference between maximum and minimum individual patient dose values varied up to a factor of 75. Reasons for these dose variations were complex but, in general, low tube potential, high mAs and low filtration were associated with high-dose hospitals. This study also demonstrated lower reference dose levels of up to 40% when compared with those established by the UK and the Commission of the European Communities for four out of six projections. Only the chest X-ray exhibited a similar reference level to those established elsewhere. This emphasizes the importance of each country establishing its own reference dose levels that are appropriate to their own radiographic techniques and practices in order to optimize patient protection.

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“…A wide range of x-ray tube operating parameters produce patient effective doses over greater than two orders of magnitude [14][15] . An assessment of the Hospital's equipment revealed that there had been no major purchases of general x-ray equipment in recent years.…”

Section: Discussionmentioning

confidence: 99%

Compliance testing of medical diagnostic x-ray equipment: three years’ experience at a major teaching hospital in Western Australia

Tuchyna

Wilkinson

Jacob

2002

Australas. Phys. Eng. Sci. Med.

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The impact of a formal compliance testing program has been evaluated three years post-implementation on a major teaching hospital (Sir Charles Gairdner Hospital) with 46 x-ray tubes located throughout 37 rooms. The mandatory program, implemented by the statutory authority in January 1997, called for all medical (including chiropractic and dental) equipment used in human diagnosis to be tested at prescribed frequencies using established protocols. The application of the required test methods demonstrated various non-compliance issues. Notices of non-compliance were received for approximately 60% of the equipment in the hospital following the equipment's first annual test. The reasons for, and the significance of, failure varied according to equipment category, test category, equipment use and equipment age. However, at the end of the third year of testing, approximately 75% of the tested x-ray units satisfied the compliance criteria. The main reasons for non-compliance were found to be design limitations of old technology and the current radiation legislation that makes it difficult for some older equipment to meet the relatively stringent criteria.

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Reference doses and quality in medical imaging.

Cited by 15 publications

References 0 publications

Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system

Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system

Reference dose levels for patients undergoing common diagnostic X-ray examinations in Irish hospitals.

Compliance testing of medical diagnostic x-ray equipment: three years’ experience at a major teaching hospital in Western Australia

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