Pediatric Radiology

, Volume 43, Issue 9, pp 1108–1116 | Cite as

Effective dose estimation for pediatric upper gastrointestinal examinations using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology

  • Brent Emigh
  • Christopher L. GordonEmail author
  • Bairbre L. Connolly
  • Michelle Falkiner
  • Karen E. Thomas
Original Article



There is a need for updated radiation dose estimates in pediatric fluoroscopy given the routine use of new dose-saving technologies and increased radiation safety awareness in pediatric imaging.


To estimate effective doses for standardized pediatric upper gastrointestinal (UGI) examinations at our institute using direct dose measurement, as well as provide dose-area product (DAP) to effective dose conversion factors to be used for the estimation of UGI effective doses for boys and girls up to 10 years of age at other centers.

Materials and methods

Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were placed within four anthropomorphic phantoms representing children ≤10 years of age and exposed to mock UGI examinations using exposures much greater than used clinically to minimize measurement error. Measured effective dose was calculated using ICRP 103 weights and scaled to our institution’s standardized clinical UGI (3.6-min fluoroscopy, four spot exposures and four examination beam projections) as determined from patient logs. Results were compared to Monte Carlo simulations and related to fluoroscope-displayed DAP.


Measured effective doses for standardized pediatric UGI examinations in our institute ranged from 0.35 to 0.79 mSv in girls and were 3–8% lower for boys. Simulation-derived and measured effective doses were in agreement (percentage differences <19%, T > 0.18). DAP-to-effective dose conversion factors ranged from 6.5 ×10−4 mSv per Gy-cm2 to 4.3 × 10−3 mSv per Gy-cm2 for girls and were similarly lower for boys.


Using modern fluoroscopy equipment, the effective dose associated with the UGI examination in children ≤10 years at our institute is < 1 mSv. Estimations of effective dose associated with pediatric UGI examinations can be made for children up to the age of 10 using the DAP-normalized conversion factors provided in this study. These estimates can be further refined to reflect individual hospital examination protocols through the use of direct organ dose measurement using MOSFETs, which were shown to agree with Monte Carlo simulated doses.


Upper gastrointestinal examination Barium meal Anthropomorphic phantom MOSFET Children 


Conflicts of interest

Authors have no conflicts of interest to declare.


  1. 1.
    Council NR (2006) Health risks of exposure to low level of ionizing radiation. BEIR VII. National Academic Press, Washington, DCGoogle Scholar
  2. 2.
    International Commission on Radiological Protection (ICRP) (2007) The 2007 Recommendations of the ICRP, Annals of the ICRP. Publication 103. Elsevier, AmsterdamGoogle Scholar
  3. 3.
    Geleijns J, Broerse JJ, Chandie Shaw MP et al (1998) A comparison of patient dose for examinations of the upper gastrointestinal tract at 11 conventional and digital X-ray units in The Netherlands. Br J Radiol 71:745–753PubMedGoogle Scholar
  4. 4.
    Hart D, Wall BF (1994) Estimation of effective dose from dose-area product measurements for barium meals and barium enemas. Br J Radiol 67:485–489PubMedCrossRefGoogle Scholar
  5. 5.
    Ruiz-Cruces R, Ruiz F, Perez-Martinez M et al (2000) Patient dose from barium procedures. Br J Radiol 73:752–761PubMedGoogle Scholar
  6. 6.
    Dimitriadis A, Gialousis G, Makri T et al (2011) Monte Carlo estimation of radiation doses during paediatric barium meal and cystourethrography examinations. Phys Med Biol 56:367–382PubMedCrossRefGoogle Scholar
  7. 7.
    Strauss KJ (2006) Pediatric interventional radiography equipment: safety considerations. Pediatr Radiol 36:126–135PubMedCrossRefGoogle Scholar
  8. 8.
    Hiorns MP, Saini A, Marsden PJ (2006) A review of current local dose-area product levels for paediatric fluoroscopy in a tertiary referral centre compared with national standards. Why are they so different? Br J Radiol 79:326–330PubMedCrossRefGoogle Scholar
  9. 9.
    Peet D, Pryor MD (1999) Evaluation of a MOSFET radiation sensor for the measurement of entrance surface dose in diagnostic radiology. Br J Radiol 72:562–568PubMedGoogle Scholar
  10. 10.
    Yoshizumi T, Goodman PC, Frush DP et al (2007) Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR Am J Roentgenol 188:1332–1336PubMedCrossRefGoogle Scholar
  11. 11.
    Glennie D, Connolly BL, Gordon C (2008) Entrance skin dose measured with MOSFETs in children undergoing interventional radiology procedures. Pediatr Radiol 38:1180–1187PubMedCrossRefGoogle Scholar
  12. 12.
    Lee R, Thomas K, Connolly B et al (2009) Effective dose estimation for pediatric voiding cystourethrography using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology. Pediatr Radiol 39:608–615PubMedCrossRefGoogle Scholar
  13. 13.
    Miksys N, Gordon CL, Thomas K et al (2010) Estimating effective dose to pediatric patients undergoing interventional radiology procedures using anthropomorphic phantoms and MOSFET dosimeters. AJR Am J Roentgenol 194:1315–1322PubMedCrossRefGoogle Scholar
  14. 14.
    Gaca A, Jaffe TA, Delaney S et al (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291PubMedCrossRefGoogle Scholar
  15. 15.
    Hollingsworth C, Yoshizumi TT, Frush DP et al (2007) Pediatric cardiac-gated CT angiography: assessment of radiation dose. AJR Am J Roentgenol 189:12–18PubMedCrossRefGoogle Scholar
  16. 16.
    Varchena V (2002) Pediatric phantoms. Pediatr Radiol 32:280–284PubMedCrossRefGoogle Scholar
  17. 17.
    Cygler J, Saoudi A, Perry G et al (2006) Feasibility study of using MOSFET detector for in vivo dosimetry during permanent low-dose-rate prostate implants. Radiother Oncol 80:296–301PubMedCrossRefGoogle Scholar
  18. 18.
    Dong SL, Chu TC, Lan GY et al (2002) Characterization of high-sensitivity metal oxide semiconductor field effect transistor dosimeters system and LiF:Mg, Cu, P thermoluminescence dosimeters for use in diagnostic radiology. Appl Radiat Isotopes 57:883–891CrossRefGoogle Scholar
  19. 19.
    Sessions J, Roshau JN, Tressler MA et al (2002) Comparisons of point and average organ dose within an anthropomorphic physical phantom and a computational model of the newborn patient. Med Phys 29:1080–1089PubMedCrossRefGoogle Scholar
  20. 20.
    Jones A, Pazik FD, Hintenlang DE et al (2005) MOSFET dosimeter depth-dose measurements in heterogeneous tissue-equivalent phantoms at diagnostic X-ray energies. Med Phys 32:3209–3213PubMedCrossRefGoogle Scholar
  21. 21.
    Cristy M (1981) Active bone marrow distribution as a function of age in humans. Phys Med Biol 26:389–400PubMedCrossRefGoogle Scholar
  22. 22.
    Cristy M (1980) Mathematical phantoms representing children of various ages for use in estimating internal dose. In: Commission UNR (ed), Oak Ridge, TNGoogle Scholar
  23. 23.
    Ward V, Strauss KJ, Barnewolt CE et al (2008) Pediatric radiation exposure and effective dose reduction during voiding cystourethrography. Radiology 249:1002–1009PubMedCrossRefGoogle Scholar
  24. 24.
    Newman B, John S, Goske M et al (2011) Pause and pulse: radiation dose in pediatric fluoroscopy. Pediatr Rev 32:e83–e90PubMedCrossRefGoogle Scholar
  25. 25.
    Staton R, Williams JL, Arreola MM et al (2007) Organ and effective doses in infants undergoing upper gastrointestinal (UGI) fluoroscopic examination. Med Phys 34:703–710PubMedCrossRefGoogle Scholar
  26. 26.
    Damilakis J, Stratakis J, Raissaki M et al (2006) Normalized dose data for upper gastrointestinal tract contrast studies performed to infants. Med Phys 33:1033–1040PubMedCrossRefGoogle Scholar
  27. 27.
    Board NRP (2002) Doses to patients from medical X-ray examinations in the UK—2000 review. National Radiological Protection Board, ChiltonGoogle Scholar
  28. 28.
    Delichas M, Hatziionannou K, Papanastassiou E et al (2004) Radiation doses to patients undergoing barium meal and barium enema examinations. Radiat Prot Dosim 109:243–247CrossRefGoogle Scholar
  29. 29.
    Hall E (2002) Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 32:700–706PubMedCrossRefGoogle Scholar
  30. 30.
    Perisinakis K, Raissaki M, Damilakis J et al (2006) Fluoroscopy-controlled voiding cystourethrography in infants and children: are the radiation risks trivial? Eur Radiol 16:846–851PubMedCrossRefGoogle Scholar
  31. 31.
    Rosenstein M, Suleiman OH, Burkhart RL et al (1992) Handbook of selected tissue doses for the upper gastrointestinal fluoroscopic examination. In: Health CfDaR (ed), Rockville, MDGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Brent Emigh
    • 1
  • Christopher L. Gordon
    • 2
    Email author
  • Bairbre L. Connolly
    • 3
  • Michelle Falkiner
    • 2
  • Karen E. Thomas
    • 2
  1. 1.Department of Medical Physics and Applied Radiation SciencesMcMaster UniversityHamiltonCanada
  2. 2.Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Image-Guided Therapy, Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoCanada

Personalised recommendations