Abstract
Modern medical imaging technology such as computed tomography (CT), fluoroscopy, mammography, and bone density measurement are very important for early diagnosis of diseases and treatment follow-up. However, patient safety and radiation dose management are essential for these devices that use ionising radiation. While dose units such as Gray and sievert are used as dose determination and exposure indicators in radiology, parameters such as skin entrance dose, dose area product, cumulative air kerma, mean glandular dose, dose length product, and CT dose index serve as critical indicators of patient exposure. These indicators play an important role in increasing patient safety and reducing adverse radiobiological effects, especially in diagnostic technologies that involve high radiation. In this study, dose units used in determining patient exposure in diagnosis and treatment follow-ups involving ionising radiation and radiation parameters used in evaluating patient irradiation in examinations will be reviewed.
Keywords: Diagnostic X-rays, radiation exposure, tomography, radiography, mammography
References
International Commission on Radiolgical Protection (ICRP), Ann ICRP (n.d.).
American Association of Physicists in Medicine (AAPM). (n.d.). AAPM Report Series. American Association of Physicists in Medicine.
Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know.Proc Natl Acad Sci USA.2003; 100: 13761-6.
Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT.AJR Am J Roentgenol.2001; 176: 289-96.
Choudhary S. Deterministic and stochastic effects of radiation.Cancer Ther Oncol Int J.2018; 12: 2.
Yeung AWK. The “As Low As Reasonably Achievable” (ALARA) principle: a brief historical overview and a bibliometric analysis of the most cited publications.Radioprotection. 2019;54:103-9.
Tsapaki V. Radiation dose optimization in diagnostic and interventional radiology: current issues and future perspectives.Phys Med.2020; 79: 16-21.
Singh S, Kalra MK, Ali Khawaja RD, Padole A, Pourjabbar S, Lira D, et al. Radiation dose optimization and thoracic computed tomography.Radiol Clin North Am.2014; 52: 1-15.
Fausto AM, Lopes MC, de Sousa MC, Furquim TA, Mol AW, Velasco FG. Optimization of image quality and dose in digital mammography.J Digit Imaging.2017; 30: 185-96.
Verdun FR, Alamo L, Miéville FA, Gudinchet F. Radiation dose management in pediatric CT.Curr Radiol Rep 1. ; 23-9.
Allisy-Roberts P, Williams J. Farr’s physics for medical imaging.Elsevier.2008.
Sweni S, Meenakshisundaram R, Thirumalaikolundusubramanian P. Cardiovascular toxicity as a result of radiological imaging.Heart and Toxins, Elsevier.2015; 521-46.
Martin CJ. Effective dose in medicine.Ann ICRP.2020; 49: 126-40.
Aanenson JW, Till JE, Grogan HA. Understanding and communicating radiation dose and risk from cone beam computed tomography in dentistry.J Prosthet Dent.2018; 120: 353-60.
Salma MU, Obayda MA, Nawreen IJ, Parvin T. Evaluating radiation exposure for patients during pelvic X-ray exams in Dhaka Metropolitan Area, Bangladesh. In:European Journal of Medical and Health Sciences.2024; 6: 30-5.
Muhdin A, Seife T. A mathematical approach evaluation of dose area product (DAP) using to patients undergoing intravenous urography examinations in Addis Ababa, Ethiopia.Int J Radiol Imaging Technol.2021; 7: 085.
Ofori K, Gordon SW, Akrobortu E, Ampene AA, Darko EO. Estimation of adult patient doses for selected x-ray diagnostic examinations.J Radiat Res Appl Sci.2014; 7: 459-62.
Asif SF. CT instrumentations. (2024).
Shirazu S, Mensah Y, Schandorf C, Mensah SY, Owusu A. Comparison of measured values of CTDI and DPL with standard reference values of different CT scanners for dose management.Int J Sci Res Sci Technol.2017; 185-90.
The imaging physicist radiology-physics education, (2017).
Li X, Hirsch JA, Rehani MM, Yang K, Liu B. Effective dose assessment for patients undergoing contemporary fluoroscopically guided interventional procedures.AJR Am J Roentgenol.2020; 214: 158-70.
Ding H, Molloi S. Quantification of breast density with spectral mammography based on a scanned multi-slit photon-counting detector: a feasibility study.Phys Med Biol.2012; 57: 4719-38.
Dance DR, Sechopoulos L. Dosimetry in X-ray-based breast imaging.Phys Med Biol.2016; 61: 271-304.
International Atomic Energy Agency (IAEA). (2010). Dual energy X-ray absorptiometry for bone mineral density and body composition assessment. In IAEA Human Health Series No. 15.International Atomic Energy Agency.
Gonera-Furman A, Bolanowski M, Jędrzejuk D. Osteosarcopenia-the role of dual-energy X-ray absorptiometry (DXA) in diagnostics.J Clin Med.2022; 11: 2522.
D. Hart, M. Hillier, B. Wall. doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK-2010 Review, 2010.
Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: an updated review.Phys Med.2021; 88: 193-217.
Delavarifar S, Nikoo MH, Jorat MV, Savardashtaki A, Sayadi M. Patients’ radiation exposure during various types of cardiac arrhythmias ablation.Int Cardiovasc Res J.2017; 11: 66-70.
Chitnavis JP, Karthikesaligam A, Macdonald A, Brown C. Radiation risk from fluoroscopically-assisted anterior cruciate ligament reconstruction.Ann R Coll Surg Engl.2010; 92: 330-4.
Lee M, Kwon J, Ryu GW, Kim KH, Nam HW, Kim KP. Review of national diagnostic reference levels for interventional procedures.Progress in Medical Physics.2019; 30: 75.
Kim B, Romeijn S, van Buchem M, Mehrizi MHR, Grootjans W. A holistic approach to implementing artificial intelligence in radiology.Insights Imaging.2024; 15: 22.
Xu L, Busch F, Adams LC, Bressem KK. Artificial intelligence in radiology and radiotherapy. In:Onkologie.2024 ; 30.
van der Bie J, van Straten M, Booij R, Bos D, Dijkshoorn ML, Hirsch A, et al. Photon-counting CT: review of initial clinical results.Eur J Radiol.2023; 163: 110829.
Cohen MD. Optimizing the use of pulsed fluoroscopy to reduce radiation exposure to children.J Am Coll Radiol. 2008; 5: 205-9.
Ali O, Kesar V, Alizadeh M, Kalachi K, Twery B, Wellnitz N, et al. Low-dose pulsed vs standard pulsed fluoroscopy during ERCP to reduce radiation without change in image quality: prospective randomized study.Endosc Int Open.2024; 12: 554-60.
