A survey of patient doses from conventional diagnostic radiology examinations : first results from Serbia and Montenegro

Olivera Ciraj, Dusko Kosutic, Milojko Kovacevic, Srpko Markovic

VINCA Institute of Nuclear Sciences, Radiation Protection Department, P.O.Box 522, 11001 Belgrade (Serbia and Montenegro)

Manuscript received: June 2, 2005; revised: September 22, 2005

Accepted for publication: October 10, 2005

Abstract

Diagnostic reference levels provide framework to reduce variability. The aim of this study is to establish, for the first time, a baseline for national diagnostic reference levels in Serbia and Montenegro for the most common X-ray examination types. Measurements of patient dose using kerma-area product meter and entrance surface air kerma assessment were performed on at least ten patients for each examination type, in each of 16 randomly selected hospitals in Serbia and Montenegro, so that a total of 3,026 procedures for nine different examination categories were included in the survey. Exposure settings and individual data were recorded for each patient. Mean, median and third quartile values of patient doses are reported. Results have shown wide variation of mean hospital doses, with a factor of four for barium enema to 23 for thoracic spine radiography. Entrance surface air kerma were compared with previously published diagnostic reference levels (DRL) proposed by Commission of European Communities (CEC). Doses for all studied examination types except chest radiography were within European DRL. The reasons for dose variation are discussed. Survey data are aimed to help in development of an on-going national quality assurance and quality control programme in diagnostic radiology. The findings emphasize the importance of regular patient dose measurement to ensure that patient doses are kept as low as reasonable achievable.

KEYWORDS: X-ray examinations, Patient exposure, Effective dose, Radiation dose.