Evaluation of Patient Radiation Doses in Skull Radiography
Authors
Chanchal Kaushik, Inderjeet Singh Sandhu, AK Srivastava
Keywords
Quality assurance and quality control, Skull X-ray, digital radiography, entrance surface air kerma, effective dose, diagnostic reference levels
Abstract
Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information.
Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA).
Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.
Conclusion: The comparison revealed that the calculated ESAK and effective dose values were less than the published literature. ESAK values reported in this study could further contribute to establishing LDRLs.
References
- Atomic energy Regulatory Board (2001). Safety Code for medical diagnostic X- ray equipment and installation. No. AERB/SC/MED-2 (Rev.1) (Mumbai, India: atomic energy regulatory board).
- Atomic energy Regulatory Board (2016). Safety code for radiation safety in manufacture, supply and use of medical diagnostic X- ray equipment. No. AERB/RFMED/SC-3 (Rev. 2).
- Bell R.S. & Loop J.W. (1971). The utility and futility of radiographic skull examination for trauma. New England Journal of Medicine, 284(5), 236-239. https://doi.org/10.1056/NEJM197102042840504
- Hart, D., Hillier, M.C. & Wall, B.F. (2007). Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK—2005 review HPA-RPD-029. HPA ISBN: 978-0-85951-600-6.
- De Gonzalez, A.B. & Darby, S. (2004). Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. The lancet, 363(9406), 345-351. https://doi.org/10.1016/S0140-6736(04)15433-0
- DeSMET, A.A., Fryback, D.G. & Thornbury, J.R. (1979). A second look at the utility of radiographic skull examination for trauma. American Journal of Roentgenology, 132(1), 95-99. https://doi.org/10.2214/ajr.132.1.95
- European Commission (EC) (2014). Diagnostic Reference Levels in Thirty-six European Countries Part 2/2. Radiation protection No. 180. Luxembourg: Publications Office of the European Union.
- Gray, J.E., Archer, B.R., Butler, P.F., Hobbs, B.B., Mettler, F.A., Pizzutiello, R.J., Schueler, B.A., Strauss, K.J., Suleiman, O.H. & Yaffe, M.J. (2005). Reference values for diagnostic radiology: application and impact. Radiology, 235(2), 354-358. https://doi.org/10.1148/radiol.2352020016
- Hall, E.J. & Brenner, D.J. (2008). Cancer risks from diagnostic radiology. The British journal of radiology, 81(965), 362-378. https://doi.org/10.1259/bjr/01948454
- Hart, D., Hillier, M.C. & Wall, B.F. (2002). Doses to patients from medical X-ray examinations in the UK-2000 review. Chilton, UK. National Radiological Protection Board.
- Hart, D., Wall, B.F., Hillier, M.C. & Shrimpton, P.C. (2010). Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. Health Protection Agency.
- Hart, D., Hillier, M. & Shrimpton, P. (2010). Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK. Chilton: Health Protection Agency Centre for Radiation, Chemical and Environmental Hazards.
- Herrmann, K., Bonel, H., Stäbler, A., Kulinna, C., Glaser, C., Holzknecht, N., Geiger, B., Schätzl, M. & Reiser, M. (2002). Chest imaging with flat-panel detector at low and standard doses: comparison with storage phosphor technology in normal patients. European radiology, 12(2), 385-390. https://doi.org/10.1007/s00330-001-1166-4
- International Atomic Energy Agency (IAEA) (2007). Dosimetry in diagnostic radiology: An International Code of Practice IAEATRS. No 457. Vienna: IAEA (2007).
- International Atomic Energy Agency (IAEA) (2004). Optimization of the radiological protection of patients undergoing radiography, fluoroscopy and computed tomography. Vienna. IAEA (2004).
- International Atomic Energy Agency (IAEA) (1995). Radiation doses in diagnostic radiology and methods for dose reduction. IAEA-TECDOC-796. Vienna: IAEA, (1995).
- Jennett, B. (1980). Skull X-rays after recent head injury. Clinical radiology, 31(4), 463-469. https://doi.org/10.1016/S0009-9260(80)80195-4
- Martin, C. J. (2007). The importance of radiation quality for optimisation in radiology: Biomedical Imaging and Intervention Journal, 3(2), e38. https://doi.org/10.2349/biij.3.2.e38
- Matthews, K. & Brennan, P.C. (2009). The application of diagnostic reference levels: General principles and an Irish perspective. Radiography, 15(2), 171-178. https://doi.org/10.1016/j.radi.2008.03.001
- Metaxas, V.I., Messaris, G.A., Lekatou, A.N., Petsas, T.G. & Panayiotakism, G.S. (2019). Patient doses in common diagnostic X-ray examinations. Radiation protection dosimetry, 184(1), 12-27. https://doi.org/10.1093/rpd/ncy169
- Radiation Protection 109 (1999). Guidance on diagnostic reference levels (DRLs) for Medical Exposures. Luxembourg. European Communities: 1999.
- Rana, B.S., Kumar, S., Sandhu, I.S. & Singh, N.P. (2018). Dosimetry of Adult And Pediatric Patients For Common Digital Radiography Examinations. Radiation protection dosimetry, 179(4), 349-357. https://doi.org/10.1093/rpd/ncx293
- Samei, E., Dobbins, I.I.I. J.T., Lo, J.Y. & Tornai, M.P. (2005). A framework for optimising the radiographic technique in digital X-ray imaging. Radiation Protection Dosimetry, 114(1-3), 220-229. https://doi.org/10.1093/rpd/nch562
- Sjöholm, B., Geijer, H. & Persliden, J. (2005). Impact of digital imaging on radiation doses to the patient during X-ray examination of the urinary tract. Acta Radiologica, 46(6), 657-661. https://doi.org/10.1080/02841850510021616
- Uffmann, M. & Schaefer-Prokop, C. (2009). Digital radiography: The balance between image quality and required radiation dose. European Journal of Radiology, 72(2), 202–208. https://doi.org/10.1016/j.ejrad.2009.05.060
- UNSCEAR (2010). Sources and effects of ionizing radiation. 2008 UNSCEAR report to the general assembly with scientific annex.
- Uniyal, S.C., Chaturvedi, V., Sharma, S.D. & Raghuvanshi, S. (2017). Estimation of entrance surface air kerma due to diagnostic X-ray examinations of adult patients in Uttarakhand, India and establishment of local diagnostic reference levels. Australasian physical & engineering sciences in medicine, 40(3), 687-694. https://doi.org/10.1007/s13246-017-0577-8
- Vañó, E., Miller, D.L., Martin, C.J., Rehani, M.M., Kang, K., Rosenstein, M., Ortiz-López, P., Mattsson, S., Padovani, R. & Rogers, A. (2017). ICRP Publication 135. Diagnostic Reference Levels in Medical Imaging. Annals of the ICRP, 46(1), 1-144.
- Wall, B.F., Haylock, R., Jansen, J.T.M., Hillier, M.C., Hart, D. & Shrimpton, P.C. (2011). Radiation risks from medical X-ray examinations as a function of the age and sex of the patient. Health Protection Agency, Centre for Radiation, Chemical and Environmental Hazards Chilton, Didcot Oxfordshire.
- Zoetelief, J., Dance, D.R., Drexler, G., Järvinen, H., Rosenstein, M., Allisy-Roberts, P., Bosmans, H., Moretti, C.J., Van Dam, J., Vañó, E., Wall, B.F., Wambersie, A., DeLuca, P.M. (2005). Patient dosimetry for X rays used in medical imaging. Journal of the Icru, 5, 1-113.
How to Cite
Chanchal Kaushik, Inderjeet Singh Sandhu, AK Srivastava. Evaluation of Patient Radiation Doses in Skull Radiography.
J. Multidiscip. Res. Healthcare. 2019, 05, 51-56
