Local Diagnostic Reference Levels for Typical Radiographic Procedures

Canadian Association of Radiologists Journal - Tập 63 - Trang 237-241 - 2012
Elena Tonkopi1, Cupido Daniels1, Mary J. Gale1, Stephanie C. Schofield1, Vicki A. Sorhaindo1, Jeanne L. VanLarkin1
1Diagnostic Imaging Department, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada

Tóm tắt

Purpose To establish local diagnostic reference levels (DRL) for typical radiographic examinations in a fully digital imaging institution. Methods The initial survey included 6 standard radiographic projections performed in 19 computed radiography (CR) and digital radiography (DR) rooms. Because of the expected difference in the performance, the local reference levels were analysed separately for those 2 modalities. Data of 226 average size adult patients were included in the analysis. Entrance surface dose (ESD) was calculated from the recorded radiographic techniques and tube radiation output measurements. After observing wide variations in the results of the patient survey, the examinations were repeated by using anthropomorphic phantoms. Initial efforts to understand the reasons for dose variations were focused on CR chest, abdomen, pelvis, and lumbar spine examinations. Results The average size patient doses for similar examinations were lower in the DR rooms than in the CR rooms by factors that ranged from 1.2 to 3, with the exception of the chest examination. Standardization of the CR exposure index value allowed us to decrease ESD by 21%-30%. Detector sensitivity had an insignificant effect (2%) on ESD; proper collimation lowered the dose by 17%. However, the major effect, up to 46% difference, was found because of antiscatter grids cutoff. Conclusion Modality specific local diagnostic reference levels for standard examinations have been established in a large digital imaging department with hybrid modalities. Typically the local reference values were lower than those recommended in Safety Code 35, except for CR chests. Factors that affect the dose variations have been investigated and determined.

Tài liệu tham khảo

10.1097/01.HP.0000326331.35187.63 International Commission on Radiological Protection Radiological Protection and Safety in Medicine. ICRP Publication 73, Annals of the ICRP 26(2) 1996 Pergamon Press Oxford European Commission European guidelines on quality criteria for diagnostic radiographic images. Publication EUR 16263 EN 1996 European Commission Brussels, Belgium Council of the European Union. Council Directive 97/43/Euratom (Medical Exposure Directive) of June 30, 1997, on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure. OJEC 1997;L180:22–7. 10.1093/rpd/nch432 10.1093/rpd/nch505 10.1259/bjr/12568539 Conference of Radiation Control Program Directors. Nationwide Evaluation of X-ray Trends (NEXT): tabulation and graphical summary of surveys 1984 through 1987. CRCPD publication no.89-3. Frankfort, Ky: Conference of Radiation Control Program Directors; 1989. 10.1148/radiol.2352020016 10.1007/s10278-006-9944-9 10.1088/0031-9155/51/21/006 10.1093/rpd/nch548 10.1093/rpd/ncm495