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Diagnostic reference levels for thorax X-ray examinations of paediatric patients

¹ Radiation Practices Regulation, Radiation and Nuclear Safety Authority, PO Box 14, FI-00881, Helsinki, ² Department of Physical Sciences, University of Helsinki, PO Box 64, FI-00014, Helsinki, ³ HUS Medical Imaging Center, University of Helsinki, PO Box 340, FI-00029, Helsinki, Finland

View larger version (20K): [in this window] [in a new window]   Figure 1. Entrance surface doses(ESD; a) and dose–area products (DAP; b) presented as a function of patient thickness with exponential curve fits in the anteroposterior (AP) or posteroanterior (PA) projection. In Armila Hospital, the doses were measured in two examination rooms with Philips Vertical Diagnost 1 (open squares) and CS-64 (solid squares). In EKKS, the immovable Philips Digital Diagnost (open circles) and the movable Siemens Mobilett Plus (solid circles) examination devices were used. The number of patients examined in AP or PA projection was 77.

View larger version (18K): [in this window] [in a new window]   Figure 2. The entrance surface doses(ESD; a) and dose–area products (DAP; b) presented as a function of patient thickness with exponential curve fits in the lateral (LAT) projection. The doses were measured in two examination rooms with Philips Vertical Diagnost 1 (open squares) and CS-64 (solid squares) in Armila Hospital, and in one examination room with a Philips Digital Diagnost (open circles) in EKKS. The number of patients examined in LAT projection was 56.

View larger version (16K): [in this window] [in a new window]   Figure 3. The third quartile values calculated for entrance surface doses(ESD; solid circles) and dose–area product (DAP; open circles) by the NRPB method in anteroposterior (AP) or posteroanterior (PA) projection (a) and in lateral (LAT) projections (b). Error bars represent the relative error of the normalization factors used in the calculation.

View larger version (16K): [in this window] [in a new window]   Figure 4. Calculated third quartile values for entrance surface doses(ESD; solid circles) and dose–area product (DAP; open circles) in chest examinations as a function of patient thickness in anteroposterior (AP) or posteroanterior (PA) projection (a) and lateral (LAT) projections (b). A very good exponential correlation (R2  =  0.99) was found between the patient doses and patient thickness in LAT projection. In AP or PA projection, correlation was good (R2  =  0.86 for ESD, R2 = 0.90 for DAP).

View larger version (19K): [in this window] [in a new window]   Figure 5. An example of comparing patient doses in hospital with the diagnostic reference levels(DRL) curve (solid line). Manually inserted patient doses are presented as solid circles, and the curve fitted to the patient dose data is presented as a dotted line. As there are more individual patient doses above the DRL curve and the curve fit is above the DRL curve, the DRL is found to have been exceeded.