Background: The characterization of the X-ray beam (kVp, mAs, filtration, focus-skin distance), the patient's anthropometric characteristics (thickness, beam projection), and the anatomical region of interest allows an estimation of skin entrance dose (Ka,e). Currently, the comparison of values obtained with Diagnostic Reference Levels (DRLs) makes it possible to identify opportunities to reduce the dose of ionizing radiation, contributing to safe and efficient radiological practice.
Aims: This experimental study aimed to quantify the entrance
surface air kerma (Ka,e) of X-ray beams in radiographic examinations, comparing
the obtained values with national and international Diagnostic Reference Levels
(DRLs).
Methodology: The research was conducted at the Department of
Medical Physics and Radiology of the Franciscan University (UFN) between June
2023 and August 2024. The X-ray beam evaluation used a dosimetric set to
measure the Air Kerma Rate (KAIR) and determine the X-ray tube output. A
phantom without water and another filled with water were employed to calculate
the backscatter factor (BSF) and estimate Ka,e for the main radiographic
examinations. Before the start of the study, quality control (QC) procedures
for the radiographic equipment were carried out according to current guidelines
and regulations to ensure accurate and reliable results.
Results: The results identified anatomical regions with the
highest radiation exposure, reinforcing the need for optimization. It was
observed that, although Ka,e values were within national limits, they exceeded
the reference values of the United Kingdom and Japan in the skull, abdomen, and
lumbar spine regions. For example, for the AP projection skull radiographic
exam, the estimated Ka,e value was 4.30 mGy, whereas in Japan, the
corresponding DRL is 3.0 mGy. Similarly, for the chest in the PA projection,
the estimated Ka,e value is 0.17 mGy, while in the United Kingdom, the
corresponding DRL is 0.3 mGy. This difference highlights the importance of
periodically updating DRLs in accordance with international recommendations and
technological advancements. Dose optimization requires continuous assessment of
image quality, proper selection of technical parameters, and implementation of
specific dose protocols. Ongoing training for radiology professionals is
essential to ensure the correct application of imaging techniques and reduce
patient exposure to ionizing radiation.
Conclusion: The results obtained demonstrate the need for
adjustments in imaging acquisition protocols, as the Ka,e values found in this
study. The methodology adopted in this study can contribute to the ongoing
education of radiology professionals, promoting the correct application of
imaging techniques and reducing patient exposure to ionizing radiation.
Furthermore, this study emphasizes the need for a multidisciplinary approach to
dose optimization, combined with quality assurance programs and continuous
professional training, ensuring greater patient safety and high-quality
diagnostic imaging.
Author (s) Details
Thiago Victorino
Claus
Universidade Franciscana - UFN/Hospital Universitário de Santa Maria -
HUSM, 97105-900, Santa Maria, RS, Brazil.
Luísa Vargas Cassol
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.
Nataly Nogueira
Favarin
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.
Laura Pizarro Trojahn
Nogueira
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.
Tobias Soares Gomes
Instituto Federal de Santa Catarina - IFSC, 88075-010, Florianópolis, SC,
Brazil.
Stefanie Camile
Schwarz
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.
Herculis Rolins
Torres
Universidade Federal de Santa Maria - UFSM/Hospital Universitário de Santa
Maria - HUSM, 97105-900, Santa Maria, RS, Brazil.
Tadeu Baumhardt
Universidade Federal de Santa Maria - UFSM/Hospital Universitário de Santa
Maria - HUSM, 97105-900, Santa Maria, RS, Brazil.
Please see the book here:- https://doi.org/10.9734/bpi/stda/v9/5107
