The quantification of radiation risks associated with radiological examinations has been a subject of interest with the increased use of X-rays. Effective dose, which is a risk-weighted measure of radiation to organs in the body associated with radiological examination, is considered a good indicator of radiological risk. We have therefore investigated patient effective doses from radiological examinations. Organ and effective doses were estimated for 94 patients who underwent computed tomography examinations and for 338 patients who had conventional radiography examinations. The OrgDose (version 2) program was used for the estimation of effective doses. The tube potential ranges: 57?kVp to 138?kVp depending on the examination and patient size. The entrance surface doses have a wide range even for the same examination: 0.44–10.31?mGy (abdomen) and 0.66–16.08?mGy (lumbar spine) and the corresponding effective dose ranges 0.025–0.77?mSv and 0.025–0.95?mSv respectively. Effective dose for adult abdomen-pelvic CT examinations ranges 5.4–19.8?mSv with a mean of 13.6?mSv and for pediatrics ranges 2.1–5.5?mSv with a mean of 2.7?mSv. The mean effective dose for adult chest and head CT examinations are 7.9 and 1.8?mSv respectively and for pediatrics are 1.7 and 1.1?mSv. 1. Introduction Diagnostic radiology imaging techniques including conventional radiography, fluoroscopy, and computed tomography (CT) procedures will continue to provide tremendous benefits to modern healthcare and the benefit derived by the patient will far outweigh the small risk associated with any properly conducted imaging modality. Nonetheless, it is important to be able to quantify the risks associated with radiological examinations of patients [1–11]. Access to such information will allow physicians and their patients to better weigh the risks of radiation exposure against the benefits afforded by various radiological examinations and hence make the best informed decisions in terms of options for other diagnostic modalities. The increase in patients undergoing radiological examinations (especially in CT) has created a great deal of interest in quantifying the risk associated with radiological examinations. Effective dose which is a risk-weighted measure of radiation to organs in the body associated with an examination(s) is considered a good indicator of radiological risk [2–6]. However, it should be realized that effective dose represents a generic estimate of risk from a given procedure for a generic model of the human body [11]. Estimated effective dose from a particular examination
References
[1]
P. C. Shrimpton and B. F. Wall, “The increasing importance of X ray computed tomography as a source of medical exposure,” Radiation Protection Dosimetry, vol. 57, no. 1–4, pp. 413–415, 1995.
[2]
R. R. Cruces, J. García-Granados, F. J. Diaz Romero, and J. Hernández Armas, “Estimation of effective dose in some digital angiographic and interventional procedures,” British Journal of Radiology, vol. 71, pp. 42–47, 1998.
[3]
ICRP-103, The 2007 Recommendations of the International Commission on Radiological Protection, Annals of ICRP, Pergamon Press, Oxford, UK, 2007.
[4]
ICRP-60, International Commission on Radiological Protection: Recommendations of the International Commission on Radiological Protection—ICRP 60. Annals of ICRP 21, Pergamon Press, Oxford, UK, 1990.
[5]
ICRP-26, International Commission on Radiological, Protection: Radiological Protection and Safety in Medicine. Annals of the ICRP 26 (ICRP Publication 73), Pergamon Press, Oxford, UK, 1990.
[6]
European Commission, “European guidelines on quality criteria for computed tomography EUR, 16262 EN, Luxemburg.Office for Official Publications of the European Communities,” 1999.
[7]
D. Hart, D. C. Jones, and B. F. Wall, “Normalised organ doses for medical X-ray examinations calculated using monte carlo techniques,” Tech. Rep. NRPB-SR262, Chilton, NRPB, 1991.
[8]
P. C. Shrimpton . Hillier MC. Lewis MA and M. Dunn, “National Radiological Protection Board, Doses from Computed Tomography (CT) Examinations in the UK—2003 Review,” Tech. Rep., Chilton, Didcot, UK, 2005.
[9]
P. C. Shrimpton, D. G. Jones, M. C. Hillier, et al., “Survey of CT practice in the UK. Part 2: dosimetric aspects,” Tech. Rep. NRPB R-249: 21-32, 1991.
[10]
D. G. Jones and P. C. Shrimpton, “Normalized organ doses for X-ray CT calculated using Monte Carlo techniques,” NRPB Software Report 250, 1993.
[11]
C. H. McCollough, J. A. Christner, and J. M. Kofler, “How effective is effective dose as a predictor of radiation risk?” American Journal of Roentgenology, vol. 194, no. 4, pp. 890–896, 2010.
[12]
International Commission on Radiation Units and Measurements, “Radiation dosimetry: X-rays generated at potentials of 5 to 150?kV,” Tech. Rep. 17, ICRU, Washington, DC, USA, 1970.
[13]
M. T. B. Toossi1 and S. M. Dastgherdi, “An assessment of organ and effective dose of patients who undertake CT examinations in two teaching hospitals of Mashhad & Isfahan,” in Proceedings of the 11th International Congress of the International Radiation Protection Association, pp. 1–7, Madrid, Spain, 2004.
[14]
J. Geleijns, J. G. Van Unnik, J. Zoetelief, D. Zweers, and J. J. Broerse, “Comparison of two methods for assessing patient dose from computed tomography,” British Journal of Radiology, vol. 67, no. 796, pp. 360–365, 1994.
[15]
K. A. Jessen, P. C. Shrimpton, J. Geleijns, W. Panzer, and G. Tosi, “Dosimetry for optimisation of patient protection in computed tomography,” Applied Radiation and Isotopes, vol. 50, no. 1, pp. 165–172, 1999.
[16]
J. E. M. Thomas and D. R. C. Tingey, “Radiation doses from computed tomography in Australia,” Australian Radiation Laboratory Report ARL/TR123, 1997.
[17]
J. E. Ngaile and P. K. Msaki, “Estimation of patient organ doses from CT examinations in Tanzania,” Journal of Applied Clinical Medical Physics, vol. 7, no. 3, pp. 80–94, 2006.
[18]
E. K. Osei and R. Barnett, “Software for the estimation of organ equivalent and effective doses from diagnostic radiology procedures,” Journal of Radiological Protection, vol. 29, no. 3, pp. 361–376, 2009.
[19]
E. K. Osei and K. Faulkner, “Fetal doses from radiological examinations,” British Journal of Radiology, vol. 72, pp. 773–780, 1999.
[20]
A. Khursheed, M. C. Hillier, P. C. Shrimpton, and B. F. Wall, “Influence of patient age on normalized effective doses calculated for CT examinations,” British Journal of Radiology, vol. 75, no. 898, pp. 819–830, 2002.
[21]
Imaging Performance Assessments of CT , (ImPACT), “CT patient dosimetry spreadsheet (V 1. 0. 4),” 2011, http://www.impactscan.org/ctdosimetry.htm.
[22]
C. M. Ma, C. W. Coffey, L. A. DeWerd et al., “AAPM protocol for 40-300 kV X-ray beam dosimetry in radiotherapy and radiobiology,” Medical Physics, vol. 28, no. 6, pp. 868–893, 2001.
[23]
Commission of the European Communities, “European guidelines on quality criteria for diagnostic radiographic images,” Report EUR 16260 EN, 1996.
[24]
International Atomic Energy Agency, “International basic safety standards for protection against ionizing radiation and for the safety of radiation sources,” IAEA Safety Series 115, IAEA, Vienna, Austria, 1996.
[25]
O. Ciraj, S. Markovi?, and D. Ko?uti?, “First results on patient dose measurements from conventional diagnostic radiology procedures in Serbia and Montenegro,” Radiation Protection Dosimetry, vol. 113, no. 3, pp. 330–335, 2005.
[26]
G. Compagnone, L. Pagan, and C. Bergamini, “Local diagnostic reference levels in standard X-ray examinations,” Radiation Protection Dosimetry, vol. 113, no. 1, pp. 54–63, 2005.
[27]
HPA Recommended national reference doses for individual radiographs on adultpatients, 2000, http://www.hpa.org.uk/Topics/Radiation/UnderstandingRadiation/UnderstandingRadiationTopics/MedicalRadiation/DiagnosticRadiology/diag_NrdRadio2000/.
[28]
G. Compagnone, L. Pagan, M. C. Baleni, F. L. Calzolaio, L. Barozzi, and C. Bergamini, “Patient dose in digital projection radiography,” Radiation Protection Dosimetry, vol. 129, no. 1–3, pp. 135–137, 2008.
[29]
B. F. Wall and D. Hart, “Revised radiation doses for typical X-ray examinations: report on a recent review of doses to patients from medical X-ray examinations in the UK by NRPB,” British Journal of Radiology, vol. 70, pp. 437–439, 1997.
[30]
D. Hart and B. F. Wall, “UK population dose from medical X-ray examinations,” European Journal of Radiology, vol. 50, no. 3, pp. 285–291, 2004.
[31]
J. Clarke, K. Cranley, J. Robinson, P. H. S. Smith, and A. Workman, “Application of draft European Commission reference levels to a regional CT dose survey,” British Journal of Radiology, vol. 73, no. 865, pp. 43–50, 2000.
[32]
H. Y. Tsai, C. J. Tung, C. C. Yu, and Y. S. Tyan, “Survey of computed tomography scanners in Taiwan: dose descriptors, dose guidance levels, and effective doses,” Medical Physics, vol. 34, no. 4, pp. 1234–1243, 2007.
[33]
D. Origgi, S. Vigorito, G. Villa, M. Bellomi, and G. Tosi, “Survey of computed tomography techniques and absorbed dose in Italian hospitals: a comparison between two methods to estimate the dose-length product and the effective dose and to verify fulfilment of the diagnostic reference levels,” European Radiology, vol. 16, no. 1, pp. 227–237, 2006.
[34]
J. E. Aldrich, A. M. Bilawich, and J. R. Mayo, “Radiation doses to patients receiving computed tomography examinations in British Columbia,” Canadian Association of Radiologists Journal, vol. 57, no. 2, pp. 79–85, 2006.
[35]
European Commission, “Radiation protection 109. Guidance on diagnostic reference levels (DRLs) for medical exposures. luxembourg: office for official publications of the European Communities,” 1999.
[36]
P. C. Shrimpton, M. C. Hillier, M. A. Lewis, and M. Dunn, “Doses from computed tomography examinations in the UK—2003 review,” Tech. Rep. NRPB-W67, Chilton, NRPB, 2004.
[37]
G. Brix, H. D. Nagel, G. Stamm et al., “Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey,” European Radiology, vol. 13, no. 8, pp. 1979–1991, 2003.