Patient doses assessment in diagnostic radiology: results for Madagascar

Full text: Objective: The purpose of this study is to survey entrance surface air kerma (ESAK) to patients in simple radiographic examinations and to perform comparison with diagnostic reference levels (DRLs) recommended by the International Atomic Energy Agency (IAEA). Methods: We performed a pilot study to develop a protocol for dose assessments in diagnostic radiology under the IAEA project, entitled 'Strengthening Radiological Protection of Patients and Control of Medical Exposure'. The entrance surface doses to adult patients were determined in terms of ESAK based on X-ray tube output measurements and X-ray exposure parameters of adult. One public hospital and four private hospitals were selected for this purpose. The average ESAK were compared to the (GLs) recommended by the IAEA for each examination. Results: The results show that there is a large variation of patient doses for common examination in these five hospitals. Patient doses varied by a factor of up to 8 and they were below DRLs for four hospitals. For one hospital, all values were greater than the DRLs. The mean ESAK range were 0.18-0.67 (Chest), 3.25-13.34 (Lumbar spine AP), 6.52-52.85 (Lumbar spine LAT), 3.10-11.50 (Abdomen AP), 3.10-11.30 (Pelvis AP) and 2.42-10.73 (Skull). Conclusion: Although most doses were below DRLs, the observed high patient doses necessitate regular patient dose assessment for optimal results. The potential for increased awareness on such optimization need is one positive impacts of this study in reducing unnecessary patient doses. From this preliminary, it was deduced that the obtained values can be useful for implementation of the regulation with regards to patient protection from medical exposure in Madagascar and for establishing GLs for national level. (author)