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Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):101-7

DOI: 10.23736/S2283-8376.17.00006-7


language: Italian

Diagnostic reference levels and energy imparted to patients during digital chest radiography

Fabiola R. CRETTI 1 , Paolo BRAMBILLA 2, Pierluigi RIZZI 1

1 Dipartimento Immagini Fisica Sanitaria ASST Papa Giovanni XXIII, Ospedale di Bergamo, Bergamo, Italia; 2 Radiologia ASST Papa Giovanni XXIII, Ospedale di Bergamo, Bergamo, Italia


BACKGROUND: In light of Italian Legislation concerning the protection of people in medical exposure, the present work aims at assessing the respect of the Diagnostic Reference Levels (DRLs) for chest examinations in our Institution and comparing, from a patient dose point of view, three different types of digital X-Ray equipment.
METHODS: Ninety-three adult subjects, imaged with fixed KV and automatic selection of mAs, were monitored. Patients’ height, weight, mAs and KAP (Kerma Area Product) were recorded; body mass indices (BMIs) were calculated and correlated to KAPs and Kair,in (Surface Air Kerma) were evaluated. A phantom - equivalent to a median thorax - was then irradiated under controlled conditions in each of the diagnostic rooms in order to estimate the “energy imparted”, the radiation dose to skin, lung and breast and the effective dose. Also, the image contrast to noise ratio (CNR) was assessed for the three machines, using a test tool.
RESULTS: Mean patient KAPs were 66-105-181mGy*cm2 (posterior-anterior view [PA]) and 217-336-716 mGy*cm2 (lateral view [LAT]) respectively for the three X-ray machines. Mean patient PA ESAKs were 0.05-0.10-0.12 mGy. For the phantom the following results were obtained: total energy imparted (PA+LAT) 2.4-3.2-7.3 mJ; dose to lung (PA+LAT): 81-167-235 μGy; dose to breast (PA+LAT): 33-71-102 μGy; dose to skin (PA): 93-127-218 μGy; effective dose (PA+LAT) 0.02 - 0.03 - 0.06 mSv for the three equipment. CNR was 0.4-0.5-2.0 respectively.
CONCLUSIONS: DRLs are respected. Significant differences are present in dose outcomes for the three X-ray machines, due to intrinsic differences in system features and exposure technique (KV and filtration).

KEY WORDS: Diagnostic imaging - Radiography - Thorax

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