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.

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.

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.

SU-E-I-34: Air Kerma to Estimated Entrance Skin Dose Look-Up Tables: A Tool to Improve Dose Awareness in the Angiography Suite

2012 ◽  
Vol 39 (6Part4) ◽  
pp. 3632-3632
Author(s):  
R Dickinson ◽  
K Kanal ◽  
D Zamora ◽  
B Stewart
Keyword(s):  
Skin Dose ◽  
Air Kerma ◽  
Angiography Suite ◽  
Entrance Skin Dose

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.

scholarly journals Patient dose measurement in common medical X-ray examinations and propose the first local dose reference levels to diagnostic radiology in Iran

2017 ◽  
Vol 23 (3) ◽  
pp. 67-71
Author(s):  
Behrouz Rasuli ◽  
Raheleh Tabari Juybari ◽  
Meysam Forouzi ◽  
Mohammad Ghorbani
Keyword(s):  
Patient Dose ◽  
Skin Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
X Ray ◽  
Anatomical Data ◽  
Patient Load ◽  
Tube Output ◽  
Patient Doses ◽  
Southwest Of Iran

Abstract Introduction: The main purpose of this study was to investigate patient dose in pelvic and abdomen x-ray examinations. This work also provided the LDRLs (local diagnostic reference levels) in Khuzestan region, southwest of Iran to help establish the NDRLs (national diagnostic reference levels). Methods: Patient doses were assessed from patient’s anatomical data and exposure parameters based on the IAEA indirect dosimetry method. With regard to this method, exposure parameters such as tube output, kVp, mAs, FFD and patient anatomical data were used for calculating ESD (entrance skin dose) of patients. This study was conducted on 250 standard patients (50% men and 50% women) at eight high-patient-load imaging centers. Results: The results indicate that mean ESDs for the both pelvic and abdomen examinations were lower than the IAEA and EC reference levels, 2.3 and 3.7 mGy, respectively. Mean applied kVps were 67 and 70 and mean FFDs were 103 and 109, respectively. Tube loadings obtained in this study for pelvic examination were lower than all the corresponding values in the reviewed literature. Likewise, the average annual patient load across all hospitals were more than 37000 patients, i.e. more than 100 patients a day. Conclusions: The authors recommend that DRLs (diagnostic reference levels) obtained in this region, which are the first available data, can be used as local DRLs for pelvic and abdomen procedures. This work also provides that on-the-job training programs for staffs and close cross collaboration between physicists and physicians should be strongly considered.

scholarly journals Entrance Skin Dose (Radiation) Measurement and Evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Nigeria

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Abiola Olawale Ilori ◽  
Gilbert Ibitola ◽  
Olanrewaju Ajanaku ◽  
Reuben Dapo Utomewore
Keyword(s):  
Health Workers ◽  
Radiation Risk ◽  
Age Groups ◽  
The State ◽  
Skin Dose ◽  
Radiation Measurement ◽  
X Ray ◽  
Entrance Skin Dose ◽  
The Mean ◽  
Measurement And Evaluation

This study was carried out on entrance skin dose (ESD) (Radiation) measurement and evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Ondo State, Nigeria. Entrance skin doses for randomly selected patients between 0-4 years, 5-9 years, 10-17 years and above 18 years old undergoing X-ray chest (Poster Anterior) examinations were measured and evaluation of the source-to-skin distance (SSD) records for the patients during the x-ray chest examinations were carried out. The mean ESD reported for chest PA projections were 66.43 µGy, 105.10 µGy, 215.76 µGy and 291.81 µGy respectively for age range 0 - 4 years, 5 - 9 years, 10 - 17 years and above 18 years. The ESD values reported in this present study were same with the NRPB recommendations of year 2000 of 50 µGy for newborn to 1-year-old, 70 µGy for 5 years and 120 µGy for 10 years old children. The values reported for age 1 to 4 years were lower than 0.1 mGy recommended and the mean ESD for age 5 to 9 years for chest PA examination was 0.11 mGy which is lower than the recommended 0.12 mGy. However, other values reported in this present study were compared with the guidance levels set by the International regulation bodies and were found to be within safe limits and they do not pose any significant health risk to the patients of all age ranges or the health workers. The effective radiation doses (ERDs) for all the age groups were computed, and by comparisons, it was found that the radiation risk factors (RRFs) are relatively low.

Diagnostic reference levels in paediatric fluoroscopy: how does a secondary referral centre compare with 2018 European guidelines?

2021 ◽  
pp. 20201269
Author(s):  
Emily Ashworth ◽  
Liam Woods ◽  
J Valmai Cook
Keyword(s):  
Age Groups ◽  
Ionising Radiation ◽  
Low Doses ◽  
Age Group ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Referral Centre ◽  
European Guidelines

Objectives: To compare diagnostic reference levels (DRLs) in paediatric fluoroscopy at a secondary referral centre with 2018 European guidelines. Secondly, to compare secondary referral centre DRLs for paediatric fluoroscopy examinations not included in European guidelines with 2010 national UK DRLs. Methods: Paediatric fluoroscopy studies were grouped by age (groups: 0, 1, 5, 10, 15 years) for examination type and analysed retrospectively, over a period of 14 years. DRLs were compared with European DRLs (micturating cystourethrograms (MCUs)) and 2010 UK national DRLs (contrast swallows and meals). Results: 1,586 studies were performed (49% MCUs; 31% meals; 9% swallows). For all age groups, DRLs for MCUs were lower than European DRLs by up to a factor 58 x (1 year age group: secondary referral centre DRL 12 mGycm2 vs European DRL 700 mGycm2). For contrast swallows and meals, 75th percentile doses were lower than 2010 UK national 25th percentile doses in all age groups. Conclusion: Maintaining low doses of ionising radiation is particularly important in paediatrics, and our study has found that it is possible to achieve low paediatric fluoroscopy doses in a secondary referral centre setting. Advances in knowledge: Our data may prove useful to other centres and could contribute towards future European DRLs.

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