ASSESSMENT OF ADULT DIAGNOSTIC REFERENCE LEVELS IN INTRAORAL RADIOGRAPHY IN TAMIL NADU REGION, INDIA

2020 ◽  
Vol 189 (4) ◽  
pp. 452-457
Author(s):  
Amal Jose ◽  
A Saravana Kumar ◽  
K N Govindarajan ◽  
P Manimaran
Keyword(s):  
Tamil Nadu ◽  
Primary Study ◽  
Intraoral Radiography ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
The Third ◽  
Air Kerma ◽  
Wide Range ◽  
Patient Doses

Abstract In the present study, incident air kerma has been measured, for six intraoral examinations, for establishing regional adult diagnostic reference levels (DRLs), in intraoral radiography, in Tamil Nadu, India. A total of 131 units, both digital (semiconductor-based) and analog (film-based) radiography systems, were selected for the study. The third quartile values, for the six intraoral examinations selected for the present study, ranged from 1.2 to 2.0 mGy, for the adult settings. The results showed a wide range of patient doses existing across the clinics or hospitals studied. This is the primary study for the establishment of adult intraoral DRL, in Tamil Nadu, one of the major states of the country. Similar studies will be undertaken in other major states across the country to establish national DRLs in intraoral radiography in the country.

AVERAGE GLANDULAR DOSES AND NATIONAL DIAGNOSTIC REFERENCE LEVELS IN MAMMOGRAPHY EXAMINATIONS IN TURKEY

2020 ◽  
Vol 190 (1) ◽  
pp. 100-107
Author(s):  
Aydın Parmaksız ◽  
Gökçe K Ataç ◽  
Emine Bulur ◽  
Tolga İnal ◽  
Aslıhan Alhan
Keyword(s):  
Age Groups ◽  
Skin Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
The Third ◽  
Air Kerma ◽  
Entrance Skin Dose ◽  
Breast Thickness

Abstract In order to establish national diagnostic reference levels for mammography examinations, entrance skin air kerma, entrance skin dose and average glandular doses (AGDs) were calculated for a total of 25 624 cranio-caudal (CC) and mediolateral oblique (MLO) projections of 6309 patients for 40–49 and 50–64 age groups. The average entrance skin air kerma and entrance skin dose values for both age groups were found to be higher in MLO projections compared with CC projections. The minimum and maximum values of AGDs were determined as 0.4 and 7.9 mGy for both projections. The maximum numbers of AGDs for CC and MLO projections were calculated in the range of 1.1–1.5 and 1.6–2.0 mGy, respectively. The third quartile values of AGDs were calculated for each compressed breast thickness between 20 and 99 mm. The first national diagnostic reference levels of the country were established for each 10-mm compressed breast thickness in mammography examinations.

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

scholarly journals Establishing local diagnostic reference levels for common orthopaedic procedures using the mini C-arm fluoroscope

2021 ◽  
Vol 94 (1117) ◽  
pp. 20190878
Author(s):  
Anna Kropelnicki ◽  
Rosemary Eaton ◽  
Alexandra Adamczyk ◽  
Jacqueline Waterman ◽  
Pegah Mohaghegh
Keyword(s):  
Radiation Exposure ◽  
Best Practice ◽  
District General Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Data Set ◽  
Dose Area Product ◽  
The Third ◽  
Retrospective Audit ◽  
Area Product

Objective: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years. Methods: This retrospective audit evaluates the end dose–area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital. We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope. Results: For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures. Advances in knowledge: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.

NATIONAL DIAGNOSTIC REFERENCE LEVELS IN INTERVENTIONAL RADIOLOGY SUITES IN LEBANON: A MULTICENTER SURVEY

2019 ◽  
Vol 187 (1) ◽  
pp. 50-60 ◽  
Author(s):  
C Rizk ◽  
J Farah ◽  
F Vanhavere ◽  
G Fares
Keyword(s):  
Radiation Protection ◽  
Pacemaker Implantation ◽  
High Dose ◽  
National Council ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Transcatheter Aortic Valve ◽  
Multicenter Survey ◽  
Area Product

ABSTRACT Air kerma-area product (PKA), cumulative air kerma at patient entrance reference point, fluoroscopy time and number of images were retrospectively collected from 15 hospitals in Lebanon for 11282 fluoroscopically-guided interventional (FGI) procedures between March 2016 and November 2018. National diagnostic reference levels (NDRLs) were established based on the third quartile of the distribution of median values of exposure parameters per department for 27 types of FGI procedures. NDRLs were in line with international DRLs except for coronary angiography (CA), percutaneous coronary interventions (PCI) and transcatheter aortic valve implantation (TAVI) which require optimisation. Additionally, following the National Council on Radiation Protection and Measurements report 168, PCI, TAVI, triple chamber pacemaker implantation, endovascular aortic repair, nephrostomy, kyphoplasty and percutaneous transhepatic biliary drainage were classified as potentially high-dose procedures with >5% of the patients with PKA exceeding 300 Gycm2. The established NDRLs will promote dose optimisation and patient radiation protection.

scholarly journals Establishment of local diagnostic reference levels for quality control in intraoral radiography

2016 ◽  
Vol 33 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Maki Izawa ◽  
Yasuo Harata ◽  
Noriyoshi Shiba ◽  
Nobuhide Koizumi ◽  
Tomonori Ozawa ◽  
...  
Keyword(s):  
Quality Control ◽  
Intraoral Radiography ◽  
Diagnostic Reference Levels ◽  
Reference Levels

Diagnostic reference levels and patient doses in computed tomography examinations in Greece

2014 ◽  
Vol 163 (3) ◽  
pp. 319-324 ◽  
Author(s):  
G. Simantirakis ◽  
C. J. Hourdakis ◽  
S. Economides ◽  
I. Kaisas ◽  
M. Kalathaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Patient Doses

scholarly journals Multicentric survey of patient doses in fluoroscopy guided diagnostic and interventional cardiac procedures: comparison with Diagnostic Reference Levels and follow-up levels for patients at risk for radiation induced skin effects

2020 ◽  
Vol 26 (1) ◽  
pp. 44-52
Author(s):  
Anna Zagorska ◽  
Desislava Ivanova ◽  
Dessislava Kostova-Lefterova ◽  
Filip Simeonov ◽  
Valeri Gelev ◽  
...  
Keyword(s):  
At Risk ◽  
Coronary Intervention ◽  
Fluoroscopy Time ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Cardiac Procedures ◽  
Patients At Risk ◽  
Radiation Induced ◽  
Patient Doses

Introduction. Interventional cardiac procedures are often associated with high patient exposure and therefore require special care in protecting patients from radiation-induced effects. Materials and methods. A retrospective study of typical patients’doses was performed in nine hospitals, with a total number of fourteen angiography systems. The typical values for kerma-area product (KAP), cumulative dose (CD) and fluoroscopy time (FT) for two of the most commonly performed procedures - percutaneous coronary intervention (PCI) and coronary arteriography (CA), were calculated and compared with the Bulgarian National Diagnostic Reference Levels (NDRL). Data analysis, regarding the risk of radiation-induced skin effects due to interventional cardiac procedures, was performed. Aim. 1) to present and analyze the typical KAP values for PCI and CA procedures in cardiology departments with high workload and to compare them with the NDRL; 2) to compare the patient doses with the follow-up levels published in Ordinance 2, to identify patients at risk for radiation-induced effects. Results. The results show that typical values for PCI and CA procedures for some of the angiography systems are higher than the NDRL. In all investigated departments there are patients with at least one exceeded follow-up level for PCI. Conclusions. The results show a potential for optimization in the departments with both high or very low typical dose or FT values. No radiation-induced effect was observed in the followed-up group of patients. The introduction of procedure with "Instruction to the patient after an interventional cardiac procedure(s) with greater complexity and a long fluoroscopy time" for patient follow-up and its regular implementation into the routine clinical practice will help for timely diagnosis and treatment of radiation-induced skin effects after cardiac procedures under fluoroscopy control.

scholarly journals Establishment of local diagnostic reference levels for typical radiography examinations in the west region of Croatia

2019 ◽  
Vol 34 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Doris Segota ◽  
Ana Diklic ◽  
Slaven Jurkovic
Keyword(s):  
Public Health ◽  
University Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
West Region ◽  
Public Health Institutions ◽  
Patient Doses ◽  
Health Institutions ◽  
Entrance Surface Air Kerma

Majority of health institutions in Croatia do not have medical physicists in diagnostic radiology. Regarding this, in the west region of Croatia collaboration between public health institution and University Hospital Rijeka was initiated in 2015. Quality Assurance program was implemented in these public health institutions during 2015 and 2016 and the next step was to assess patient doses for the most frequent X-ray examinations. This included five public health institutions: 1 university hospital, 1 general hospital, 1 special hospital, 2 public health institutions with 13 facilities. The aim of this study was to carry out assessment of patient doses and to establish local diagnostic reference levels of entrance surface air kerma for every institution for six most frequent X-ray examinations. Also, local diagnostic reference levels for the whole west region of Croatia were established and compared with the national diagnostic reference levels and latest published data. Median entrance surface air kerma values for thorax PA, thorax LAT, cervical spine AP, thoracic spine AP, lumbar spine AP, pelvis AP and sinuses are 0.14 mGy, 0.50 mGy, 0.52 mGy, 1.50 mGy, 2.52 mGy, 2.03 mGy, and 1.03 mGy, respectively. Diagnostic reference levels proposed for our region were comparable with other studies.

scholarly journals Patient doses in computed tomography: An assessment of local diagnostic reference levels in a large teaching hospital

2012 ◽  
Vol 27 (3) ◽  
pp. 305-310 ◽  
Author(s):  
Darka Hadnadjev ◽  
Danijela Arandjic ◽  
Sanja Stojanovic ◽  
Olivera Ciraj-Bjelac ◽  
Predrag Bozovic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Dose Reduction ◽  
Teaching Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Large Teaching Hospital ◽  
Tube Current ◽  
Patient Doses ◽  
Computed Tomography Dose Index

This paper presents an estimation of local diagnostic reference levels in computed tomography in a large teaching hospital. Local diagnostic reference levels, expressed in terms of volume weighted computed tomography dose index and dose-length product, were estimated for three most frequent adult computer tomography examinations: head, abdomen and pelvis combined, and thorax. The established local diagnostic reference levels values were similar or slightly higher compared to the available guidelines, indicating the possibility for optimization of current practice. Analyzing the protocols used here and recently published studies on dose reduction in computed tomography, a dose-reduction technique, was proposed to decrease tube current values in all three examinations. However, the optimization should be restricted only to standard-sized patients.

PROPOSAL FOR LOCAL DIAGNOSTIC REFERENCE LEVELS IN GENERAL RADIOGRAPHY IN JAPAN

2019 ◽  
Author(s):  
Yasuki Asada ◽  
Koji Ono ◽  
Yuya Kondo ◽  
Kazuma Sugita ◽  
Takuma Ichikawa ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Distributions ◽  
X Ray ◽  
Non Invasive ◽  
Air Kerma ◽  
Aichi Prefecture

Abstract The present study aimed to propose local diagnostic reference levels (DRLs) formulated by calculating entrance surface doses for general radiography at 20 facilities of Aichi prefecture in Japan, by comparing these values with DRLs established in Japan in 2015 (DRLs 2015) and assessing radiation dose differences among facilities. X-ray outputs (half-value layer and air kerma) of each facility were measured with a non-invasive type of detector. The results were employed to formulate local DRLs based on the 75th percentiles of dose distributions. These local DRLs were lower than the DRLs 2015 for all examinations. If proposed local DRLs from other 46 prefectures can be collected, this paper can be used to benefit the next effort to draft better DRL for Japan.

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