3,214 research outputs found

    Variation of Pediatric Doses Undergoing Digital and Computed Radiography Examination in Addis Ababa, Ethiopia

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    BACKGROUND: Various researchers who carried out national and international surveys have reported wide variations in patient dose arising from specific X-ray examinations. Thus, assessment of radiation dose is an essential part in the optimization process. The aim of this study was to compare the entrance surface doses delivered to pediatric patients undergoing digital and computed radiography X-ray examination.MATERIAL AND METHODS: A cross-sectional study was conducted on 389 pediatric X-ray projections less than 15 years of age on eight X-ray machines in Addis Ababa in February 2009 E.C. The tube output of the X-ray machines in air was measured using RaySafe XI dosimeters. Then, entrance surface dose was estimated for common x-ray examinations like chest, skull, extremities and pelvis using established relation between X-ray tube output and radiographic parameters. These data were analyzed statistically using computer (Excel and SPSS method).RESULT: The third quartile estimated ESDs in mGy for both computed and digital radiography examinations of chest (AP) for age (0-1 year) were 0.24 and 0.15, (1-5 year) 0.3and 0.16. For the age group (5-10 year), it was 1.97 and 0.26 and for the(10-15 year)group, 0.56 and 0.18 respectively.These values were higher than those of the United Nations Scientific Committee’s on the Effects of Atomic Radiation’s established dose reference levels(in mGy for age (0-1 year) 0.02, (1-5 year) 0.03, (5-10 year) 0.04, and (10-15 year) 0.05 respectively).CONCLUSION: The wider dose variation between computed and digital radiography shows that there is a pressing need to minimize the detriment caused by unnecessary computed radiography

    Unintended and accidental medical radiation exposures in radiology: guidelines on investigation and prevention

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    This paper sets out guidelines for managing radiation exposure incidents involving patients in diagnostic and interventional radiology. The work is based on collation of experiences from representatives of international and national organizations for radiologists, medical physicists, radiographers, regulators, and equipment manufacturers, derived from an International Atomic Energy Agency Technical Meeting. More serious overexposures can result in skin doses high enough to produce tissue reactions, in interventional procedures and computed tomography, most notably from perfusion studies. A major factor involved has been deficiencies in training of staff in operation of equipment and optimization techniques. The use of checklists and time outs before procedures commence, and dose alerts when critical levels are reached during procedures can provide safeguards to reduce risks of these effects occurring. However, unintended and accidental overexposures resulting in relatively small additional doses can take place in any diagnostic or interventional X-ray procedure and it is important to learn from errors that occur, as these may lead to increased risks of stochastic effects. Such events may involve the wrong examinations, procedural errors, or equipment faults. Guidance is given on prevention, investigation and dose calculation for radiology exposure incidents within healthcare facilities. Responsibilities should be clearly set out in formal policies, and procedures should be in place to ensure that root causes are identified and deficiencies addressed. When an overexposure of a patient or an unintended exposure of a foetus occurs, the foetal, organ, skin and/or effective dose may be estimated from exposure data. When doses are very low, generic values for the examination may be sufficient, but a full assessment of doses to all exposed organs and tissues may sometimes be required. The use of general terminology to describe risks from stochastic effects is recommended rather than calculation of numerical values, as these are misleading when applied to individuals

    Evaluation of Patient Radiation Doses in Skull Radiography

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    Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information. Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA). Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.Conclusion: The comparison revealed that the calculated ESAK and effective dose values wereless than the published literature. ESAK values reported in this study could further contribute toestablishing LDRLs

    Estimation of entrance surface dose to adult patients undergoing plain chest radiographic examinations in a Northern Nigerian population.

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    Objective: The entrance surface doses (ESD) to adult patients undergoing postero-anterior (PA) chest radiography were measured at Shika Ahmedu Bello University Teaching Hospital (ABUTH) Zaria, Northern Nigeria. Method:A total of 30 patients were prospectively considered in the study. The ESDs were obtained using thermo luminescence dosimeter (TLDs) chips, and Kumar's formula. Results: The estimated ESD obtained were 1.08 mGy and 0.76 mGy for TLD chips readings and Kumar's formula respectively. Comparison was made between the two readings, and a statistically significant difference was noted (p<0.029). Conclusion: Procedural changes are suggested in order to lower the ESD and enhance the image quality of the radiographs. ESDs in this study were found to be generally higher compared with those reported in similar studies in Southern Nigeria, UK, and CEC. The results call for improved operators technique and application of quality Assurance Programme (QAP) in radiology departments, to ensure that doses are kept as low as reasonably achievable, and also for the formulation of local diagnostic reference levels (LDRL)

    Application of Dose Area Product (DAP) to Estimate Entrance Surface Dose (ESD) in Pediatric Chest X-Rays

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    Introduction: Given the high radiation tissue sensitivity of pediatric patients, it is necessary to monitor their received dose to optimize radiation protection. The first aim of this study was to evaluate the entrance surface dose (ESD) in pediatric patients undergoing a chest X-ray at the main hospital of Dezful, Iran. The second aim was to compare our results with the established dose reference levels (DRLs). Materials and Methods: The studied population included 204 pediatric patients less than 15 years who were referred to as chest X-ray. A calibrated dose area product meter (DAP-meter) with permanent installation on the X-ray unit was used to radiation dose measurements. For each patient, the demographic data, exposure parameters and the dose read by DAP-meter were recorded and ESD was calculated using a standard mathematical formula. Results: The average value of ESD was 119 μGy in patients less than 15 years. This value was 51.3, 122.3, 131.5 and 171.2 μGy for the age groups for less than 1 year, 1 to 5 years, 5 to 10 years and 10 to 15 years, respectively. A statistically significant difference was seen between ESD values ​​in different age groups (P<0.001), whereas no statistical difference was seen between ESD values in ​ girls and boys (P =0.993). Conclusion: Pediatric patients in hospital investigated (except age group less than 1 year) are subjected to unnecessary radiation exposure, especially due to the use of non-optimize X-ray protocols

    Diagnostic radiographic examinations in Saudi Arabia based on thermoluminescent dosimetery

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    This study was performed as part of a comprehensive project to establish national diagnostic reference levels (NDRLs), for the first time, in Saudi Arabia. The study consisted of 240 patients who were referred for x-ray examinations at King Khalid University Hospital (KKUH) in Saudi Arabia. Patients’ information and exposure parameters for eight of the common x-ray examinations (12 standard projections) were evaluated. The patient mean dose values recorded at KKUH were compared with the corresponding values at other national institutions (Security Forces Hospital and King Abdul-Aziz City for Science and Technology). The patient exposure parameters of several radiographic projections [chest (posterior anterior), skull (anterior posterior/posterior anterior and lateral), cervical spine (anterior posterior and lateral) and lumbar spine (anterior posterior and lateral)] measured at KKUH were compared with their corresponding values at the International Hospitals (Iran, United Kingdom and Malaysia). We found that the patient mean dose values recorded at KKUH varied widely from those recorded at the other national institutions. In addition, the patient exposure parameters recorded at KKUH varied from those measured at the international hospitals. Variations in patient dose arising from a specific X-ray examination may emerge from complex causes, but in general, low peak kilovolt and high milli Amperes were associated with the higher doses. The results of this study will prove useful information for the formulation of NDRLs and also provide local diagnostic reference levels for several diagnostic x-ray examinations at KKUH, other national institutions and international hospitals.Key words: Harshaw 3500 reader, national hospitals, radiographic examinations, thermoluminescent dosimeters, x-rays

    Visual Grading Analysis of image quality in pediatric abdominal images acquired by Direct Digital Radiography and Computer Radiography Systems

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    The advent of digital technology allowed for great improvements in radiology and lead the way for digital radiology, leaving behind conventional x-ray techniques, [1]. Digital post-processing of image is the main advantage of digital image systems (e.g., computed radiology and direct digital radiology) over the conventional systems. Image quality can indeed be improved avoiding the increase of patient dose and the number of unnecessary exposures [1-3]. Image quality is directly linked to the dose of radiation applied to the patient. The literature points out the need for appropriate image evaluation in order to reduce the patient dose. Optimization and practice justification are of great relevance in diagnostic radiology. In pediatric patients a good practice justification is even more important as radiation exposure on the first 10 years of life increases the possibility of negative effects on the patient's health compared to an exposure between the ages of 30 to 40 years old [4, 5]. In the past, the main concern of radiology technicians was image quality, leaving radiation dose to a second plan. Nowadays, dose reduction and the cost/benefit ratio represent the main concerns in radiology. The radiographer is responsible for applying the ALARA (As Low As Reasonable Acceptable) concept in every study involving the use of ionizing radiation [4, 6]. According to the ALARA concept, the necessary level of diagnostic image quality should be attained with the lowest patient dose possible. In Pediatric radiology, besides the ALARA principle, the International Commission on Radiological Protection (ICRP) adds a new concept - the SMART message, also related with optimization and radiation protection when applied to pediatric radiology (Figure 1) [6]

    Suggested Local Diagnostic Reference Levels for Possible Pediatric X-Ray Optimization in Addis Ababa, Ethiopia

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    BACKGROUND: Early childhood radiation exposure carries an enhanced radiation risk of about two to three times as high as in adults. The objective of this study was to determine local diagnostic reference levels for the most frequent pediatric x-ray examinations in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted on 18 public and private hospitals/clinics in Addis Ababa. A total of 864 pediatric patients, undergoing eight types of routine x-ray examinations with 13 projections were evaluated from December 18/2017 to March 17 /2018. All pediatrics were categorized under four age groups. Anthropometric and radiographic parameters of each patient were recorded .The minimum, maximum, mean and third quartile values of entrance surface dose were analyzed using SPSS version 23. Finally, the suggested local diagnostic reference levels were compared with national and international reference dose values. RESULTS: Of the 864 pediatric patients, chest (AP/PA), lower and upper extremity (AP/PA) accounted for 501(58%), 110 (13%) and 103 (12%) respectively, accounting to 714(83%) of the total pediatric x-ray examinations. The suggested local diagnostic reference levels  of  chest X-ray (AP/PA) examinations in mGy were: (0.09,0.13,0.17,0.17) for age group (0-<1,1-<5 ,5-<10, and 10-<15), respectively. Similarly, for same  age group (0-<1,1-<5 ,5-<10, and 10-<15)  the  suggested local diagnostic reference levels  of  lower and upper extremities  in mGy were:  (0.06,0.08,0.09,0.09) and (0.04,0.05,0.05,0.06), respectively.  CONCLUSION: The suggested local diagnostic reference levels   were slightly higher than the national and international guidance levels, indicating the need for establishment of diagnostic reference levels in the country

    Availability and utilisation of radiation protection and safety measures by Medical Imaging Technologists in Rwandan Hospitals

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    Abstract: Medical imaging technologists (MITs) are taught and use techniques and protective devices to keep radiation to a minimum, to themselves, patients and the environment, through but not limited to shielding, employing appropriate distances, optimum radiographic exposures, and use of techniques such as good communication, immobilization, beam limitation, justification for radiation exposure and quality control programmes. Following the enactment of the new law relating to radiation protection in 2018, it was relevant to interrogate the current state of radiology departments to establish whether they are equipped for implementation of the new regulations. The aim of this study therefore, was to assess the availability and utilization of radiation and safety measures by medical imaging technologists in Rwandan Hospitals. A quantitative non-experimental descriptive method study design was used and data was collected by means of a questionnaire which was developed by the researcher using studies conducted in other jurisdictions and adapted to suit the local context to achieve the aim and target all the MITs in the public hospitals. One hundred and sixteen (116) representing 96.67% of expected participants from public hospitals participated in the study. The participants came from 44 (91.67%) of the total of 48 public hospitals. The study found that radiation safety measures were not adequately implemented as 40.87% of MITs did not have radiation-measuring devices, with 29% of those having the devices, not receiving results consistently. Lead rubber aprons were mostly vi available for 99.13%, however, 59% of participants had never checked their integrity. A Pigg-o-stat was the least available at 0.86%. 36.8% of MITs blamed neglect by administrators as a reason for non-availability of the radiation equipment. Participants mostly used lead rubber aprons (93.04%) and lead equivalent barriers (83.62%). There was a lack of adequate radiation safety equipment while quality management, use of exposure charts and use of immobilizing devices as techniques for radiation safety were not implemented. It was evident that education and experience did not influence the radiation safety practice. Barriers to radiation safety were negligence, lack of equipment and difficulty in using some of the equipment. There is a need for a concerted effort between RURA, the Ministry of Health, training institutions and hospital managements to improve the culture of radiation safety.M.Tech. (Radiography

    Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review

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    Shielding has been recommended as an effective tool against radiation exposure. Several studies have published on the availability and use of shielding tools in diagnostic X-ray centers across the country and contradictory results been reported. Therefore, the aim of this systematic review was to find out the status of radiation protection in term of availability and use of shielding tools in diagnostic X-ray centers in Iran. An extensive literature search was conducted in the PubMed/Medline, Embase, ISI, Cochrane Library, SID, Magiran, IranMedex, Irandoc and Google-Scholar search engine. We also manually searched the reference lists of the relevant studies. Two authors independently assessed the eligibility of all studies and extracted data. Thirty-seven studies published from 1998 to 2019 were included in this systematic review. In all, 1089 diagnostic X-ray centers, 4439 radiographs and performance of 1472 radiographers were covered in these studies. The availability of lead apron, gonad shield and thyroid collar were ranged from 7 to 95.5%, 26.6 to 94% and 7 to 94%, respectively. Moreover, their usage was ranged from 0 to 85.5%, 0 to 35% and 0 to 38.4%, respectively. In addition, lens shield was discussed in one study with availability of 0%. During 1998 to 2019, the status of shielding had not improved across the country. Therefore adherence to the safety guideline as far as possible is required to protection patients from undue exposure to radiation
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