Assessment of the Entrance Skin Radiation Dose from the Digital Radiography in Srinagarind Hospital
Keywords:
Digital Radiography; Entrance Skin Dose; Diagnostic reference levelAbstract
Background and objectives: Digital radiography is a common diagnostic practice and it has been a significant increase in the number of x-ray examinations. Patients were frequently exposed to radiation may consider increasing the risk of exposure to radiation. The purpose of this study was set up to evaluate the entrance skin dose (ESD) in common digital radiography in Srinagarind hospital, faculty of medicine, Khon Kaen university and compared to ESD with national and international diagnostic reference level (DRL) including study of parameters which effect the ESD.
Material and method: The retrospective study was conducted from January to May 2019 by using picture achieving communication systems (PACS). The digital radiographic parameters from total 1,010 patients from 12 examinations including chest, cervical spine, thoracic spine and lumbar spine, skull in anteroposterior/posteroanterior (AP/PA) view and lateral view, abdomen and pelvis in AP view were recorded. The ESD was calculated using the specific formula. All data were analyzed using descriptive analysis and the correlation of digital radiographic parameters and ESD was also analyzed.
Result: The result showed that the highest kVp for DR was observed in chest LAT while the highest mAs was observed in lumbar spine LAT. The median ESD of all digital radiography examination was lower than the international IAEA DRL value while the median of ESD of chest PA, abdomen AP, pelvis AP, lumbar spine LAT and skull AP/PA was lower than Thai national DRL except for the median ESD of lumbar spine AP and skull LAT were higher than national DRL. Moreover, the median ESD was compared with the Japanese and United Kingdom (UK) DRL. The comparison between ESD and Japanese DRL was showed the result like the Thai national DRL. While the comparison between ESD and UK DRL, the median ESD of abdomen AP, pelvis AP and lumbar spine LAT were lower than UK DRL except for the median ESD of chest PA, lumbar spine AP, skull AP/PA and skull LAT were higher than UK DRL. In addition, mAs showed a high positive correlation with ESD while weight, age and kVp were showed a low correlation with ESD.
Conclusion: This study provided the median ESD in Srinagarind hospital and already compared with national DRL, international IAEA DRL, Japanese DRL and UK DRL. When the median ESD was higher than national and international DRL, technologist and team member could investigate and determine the cause of problem. The quality assurance program and efficiency of X-ray machine firstly check to ensure the good performance of the machine and radiation output and then the protocol and exposure technique were also revised. Further step, dose optimization is required to reduce the patient dose and limit the stochastic effect risk.
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