The British Journal of Radiology, Vol 69, Issue 826 929-937, Copyright © 1996 by British Institute of Radiology

ARTICLES

Radiology in the neonatal intensive care unit: dose reduction and image quality

BJ McParland, W Gorka, R Lee, DB Lewall and MF Omojola
Department of Medical Imaging, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.

This paper describes a prospective study of the diagnostic radiation doses received in a neonatal intensive care unit (NICU) for a representative radiological technique used at our institution for a number of years and a "low dose" technique similar to that recommended by the Commission of the European Communities (CEC). A 400 speed film-screen combination was used in both techniques. A total of 363 anteroposterior (AP) chest and abdominal films of 77 neonates were accrued. For each radiograph, the entrance skin dose (FSD), energy imparted (EI) and mean whole body dose were determined. For a neonatal AP chest, there was an 18% reduction in the mean ESD per radiograph from 20.0 muGy for the representative technique to 16.4 muGy for the low dose technique (p < 0.0005). The reduction in the mean EI per radiograph values for the two techniques from 7.9 muJ to 7.1 muJ (10%) was statistically significant at the p < 0.017 level, after compensating for the difference in mean field dimensions between the two patient cohorts. The mean whole body dose per radiograph reduction from 4.4 to 3.5 muGy (20%) was statistically significant at the p < 0.0028 level. It was determined that the ESD and EI could be fitted by an exponential function in the equivalent patient diameter, a single parameter indicative of neonate size. Absolute excess childhood cancer mortality risk per film was estimated using risk factors derived for fetal exposures. A "worst case" absolute excess mortality risk per chest radiograph was estimated to be 1.40 x 10(-7) for the conventional technique and was further reduced to 1.11 x 10(-7) for the low dose technique. A blind comparison of patient-matched film pairs for each technique was performed by three radiologists using criteria similar to those specified by the CEC. No statistically significant difference in clinical image quality was found between the two techniques.

This article has been cited by other articles:

				E D Dougeni, H B Delis, A A Karatza, C P Kalogeropoulou, S G Skiadopoulos, S P Mantagos, and G S Panayiotakis Dose and image quality optimization in neonatal radiography Br. J. Radiol., October 1, 2007; 80(958): 807 - 815. [Abstract] [Full Text] [PDF]

				J. Donadieu, A. Zeghnoun, C. Roudier, C. Maccia, P. Pirard, C. Andre, C. Adamsbaum, G. Kalifa, P. Legmann, and P.-H. Jarreau Cumulative Effective Doses Delivered by Radiographs to Preterm Infants in a Neonatal Intensive Care Unit Pediatrics, March 1, 2006; 117(3): 882 - 888. [Abstract] [Full Text] [PDF]

				L Duggan, H Warren-Forward, T Smith, and T Kron Investigation of dose reduction in neonatal radiography using specially designed phantoms and LiF:Mg,Cu,P TLDs Br. J. Radiol., April 1, 2003; 76(904): 232 - 237. [Abstract] [Full Text] [PDF]

				C I Armpilia, I A J Fife, and P L Croasdale Radiation dose quantities and risk in neonates in a special care baby unit Br. J. Radiol., July 1, 2002; 75(895): 590 - 595. [Abstract] [Full Text] [PDF]

				N F Jones, T W Palarm, and I S Negus Neonatal chest and abdominal radiation dosimetry: a comparison of two radiographic techniques Br. J. Radiol., October 1, 2001; 74(886): 920 - 925. [Abstract] [Full Text] [PDF]