Abstract
Background
Little information exists concerning appropriate exposure and measuring overall patient dose in pediatric digital radiography.
Objective
To establish a convenient method of appropriate exposure from target exposure index (EI) and thickness in pediatric digital radiography and estimate patient entrance-surface dose (ESD) and dose-area product (DAP) associated with chest, abdomen and pelvis radiography.
Materials and methods
A formula was deduced to calculate appropriate mAs changed with children’s weight and height. EI was used to control image quality. With this formula, dose-optimized procedures were carried out. Data were collected from 180 pediatric examinations, including chest, abdomen and pelvis anterior-posterior (AP) projections. The children were divided into the following age bands: newborns (0–28 days), infants (28 days-2 years) and older children (2–7 years). In each age band, ten children were exposed with the calculated appropriate mAs and EI values were kept steady in appropriate range (referred as target group) and ten children were exposed to the factors routinely used in practice (referred to as the routine group). DAP to children was measured with a DAP meter, and ESD was calculated using measured DAP and data from the National Radiological Protection Board. Data were compared between groups.
Results
ESD ranges in the target group were 32–202 μGy (chest AP), 57–333 μGy (abdomen AP) and 52–372 μGy (pelvis AP). For every radiographic procedure, chi-square Student’s t tests showed a significant difference in average ESD and DAP between the two groups (P < 0.005). Most ESD values from the routine group were two times higher than those from the target group.
Conclusions
The study established a convenient method to set appropriate exposure parameters (mAs) to reach a target EI using the child’s weight and height in pediatric radiography. By this method, ESD and DAP can be significantly reduced in children.
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References
UNSCEAR (1988) Sources, effects and risks of ionizing radiation. UNSCEAR report. United Nations Committee on the Effects of Atomic Radiation, Vienna
International Commission on Radiological Protection (1991) 1990 Recommendations of the international commission on radiological protection, ICRP publication 60. Pergamon, Oxford
National Council on Radiation Protection and Measurements (1981) Radiation protection in pediatric radiology, NCRP Report No. 68. NCRP, Bethesda
European Commission (1996) European guidelines on quality criteria for diagnostic radiographic images in pediatrics, Report EUR 16261. Office for offcial publications of the European Communities, Luxembourg
Mazonakis M, Damilakis J, Raissaki M et al (2004) Radiation dose and cancer risk to children undergoing skull radiography. Pediatr Radiol 34:624–629
Neitzel U (2004) Management of pediatric radiation dose using Philips digital radiography. Pediatr Radiol 34(Suppl 3):s227–s233
International Commission on Radiological Protection (2004) Managing patient dose in digital radiology. ICRP publication 93. Elsevier, The Netherlands
Schaefer-Prokop C, Neitzel U, Uffmann M et al (2008) Digital chest radiography: an update on modern technology, dose containment and control of image quality. Eur Radiol 18:1818–1830
International Electrotechnical Commission (2008) Medical electrical equipment—exposure index of digital x-ray imaging systems—part 1: definitions and requirements for general radiography. IEC 62494–1:5
Warren-Forward H, Arthur L, Hobson L et al (2007) An assessment of exposure indices in computed radiography for the posterior-anterior chest and the lateral lumbar spine. Br J Radiol 80:26–31
American Association of Physicists in Medicine (2009) Recommended exposure indicator for digital radiography. Report of AAPM task group #116
National Radiological Protection Board (2000) Reference doses and patient size in pediatric radiology. NRPB-R318, NRPB, Chilton
European Commission (1996) European guidelines on quality criteria for diagnostic radiographic images. EUR 16260
National Radiological Protection Board (1992) National protocol for patient dose measurements in diagnostic radiology. Didcot, Oxford, Chilton
Schaefer-Prokop C, Neitzel U, Venema HW et al (2008) Digital chest radiography: an update on modern technology, dose containment and control of image quality. Eur Radiol 18:1818–1830
Zhang M, Chu C (2012) Optimization of the radiological protection of patients undergoing digital radiography. J Digit Imaging 25:196–200
Davies M, McCallum H, White G et al (1997) Patient dose audit in diagnostic radiography using custom designed software. Radiography 3:17–25
Rassow J, Schmaltz A, Hentrich F et al (2000) Effective doses to patients from pediatric cardiac catheterization. Br J Radiol 73:172–183
Vano E, Martinez D, Fermandez JM et al (2008) Paediatric entrance doses from exposure index in computed radiography. Phys Med Biol 53:3365–3380
American Association of Physicists in Medicine (2002) Quality control in diagnostic radiology. AAPM Report 74, Madison
American College of Radiology (2006) ACR technical standard for diagnostic medical physics performance monitoring of radiographic and fluoroscopic equipment. ACR, Reston
Mansson LG (2000) Methods for the evaluation of image quality: a review. Radiat Prot Dosim 90:89–99
Peters S, Brennan P (2002) Digital radiography: are the manufacturers’ settings too high? Optimization of the Kodak digital radiography system with aid of the computed radiography dose index. Eur Radiol 12:2381–2387
Seibert JA, Morin RL (2011) The standardized exposure index for digital radiography: an opportunity for optimization of radiation dose to the pediatric population. Pediatr Radiol 41:573–581
American College of Radiology (2007) Practice guideline for digital radiography. Available via http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/dx/digital_radioraphy.asp. Accessed 17 June 2010
Martin CJ, Farquhar B, Stockdale E et al (1994) A study of the relationship between patient dose and size in paediatric radiology. Br J Radiol 67:864–871
Mooney R, Thomas PS (1998) Dose reduction in a paediatric X-ray department following optimization of radiographic technique. Br J Radiol 71:852–860
European Commission (1999) Radiation protection 109: guidance on diagnostic reference levels (DRLs) for medical exposures. EC
Kyriou JC, Fitzgerald M, Pettett A et al (1996) A comparison of doses and techniques between specialist and non specialist centers in the diagnostic X-ray imaging of children. Br J Radiol 69:437–450
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Zhang, M., Liu, K., Niu, X. et al. A method to derive appropriate exposure parameters from target exposure index and patient thickness in pediatric digital radiography. Pediatr Radiol 43, 568–574 (2013). https://doi.org/10.1007/s00247-012-2555-3
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DOI: https://doi.org/10.1007/s00247-012-2555-3