Real-Time Patient Radiation Dose Monitoring System Used in a Large University Hospital.

Radiation dose monitoring in medical imaging examination areas is mandatory for the reduction of patient radiation exposure. Recently, dose monitoring techniques that use digital imaging and communications in medicine (DICOM) dose structured reports (SR) have been introduced. The present paper discusses the setup of a radiation dose monitoring system based on DICOM data from university hospitals in Korea. This system utilizes the radiation dose data-archiving method of standard DICOM dose SR combined with a DICOM modality performed procedure step (MPPS). The analysis of dose data based on a method utilizing DICOM tag information is proposed herein. This method supports the display of dose data from non-dosimeter-attached X-ray equipment. This system tracks data from 62 pieces of equipment to analyze digital radiographic, mammographic, mobile radiographic, CT, PET-CT, angiographic, and fluorographic modalities.

Evaluation based on Monte Carlo simulation of lifetime attributable risk of cancer after neck X-ray radiography.

At present, concern regarding radiation exposure is increasing with the prevalence of radiologic examination. As radiation damages the human body, we have evaluated medical radiation dose values and studied the importance of optimizing radiation exposure. We measured entrance surface dose (ESD) values using a RANDO(®) phantom (neck) in 94 randomly selected locations in the central region of Korea. Thyroid and organ doses were calculated using Monte Carlo simulations (PCXMC 2.0.1) based on measured values. In addition, the lifetime attributable risk (LAR) of cancer was calculated for the thyroid, using the method proposed in the biological effects of ionizing radiation VII report. The average measured ESD values obtained using the RANDO(®) phantom (neck) were antero-posterior 1.33 mGy and lateral 1.23 mGy, for a total of 2.56 mGy. Based on the ESD values measured using the phantom, the organ doses were obtained using a Monte Carlo simulation (PCXMC 2.0.1). The thyroid dose was 1.48 mSv on average. In evaluating the LAR of thyroid cancer incidence, a frequency of 0.02 per 100,000 from 2.94 per 100,000 males and a frequency of 0.10 per 100,000 from 16.23 per 100,000 females were found. The risk of cancer was found to be higher when the patient's age was lower, and was also higher in females than in males. It was concluded that beneficial exams in the medical field should not be prohibited because of a statistically small risk, although acknowledgement of the dangers of ionizing radiation is necessary.

Development of Diagnostic Reference Levels Using a Real-Time Radiation Dose Monitoring System at a Cardiovascular Center in Korea.

Digital cardiovascular angiography accounts for a major portion of the radiation dose among the examinations performed at cardiovascular centres. However, dose-related information is neither monitored nor recorded systemically. This report concerns the construction of a radiation dose monitoring system based on digital imaging and communications in medicine (DICOM) data and its use at the cardiovascular centre of the University Hospitals in Korea. The dose information was analysed according to DICOM standards for a series of procedures, and the formulation of diagnostic reference levels (DRLs) at our cardiovascular centre represents the first of its kind in Korea. We determined a dose area product (DAP) DRL for coronary angiography of 75.6 Gy cm(2) and a fluoroscopic time DRL of 318.0 s. The DAP DRL for percutaneous transluminal coronary intervention was 213.3 Gy cm(2), and the DRL for fluoroscopic time was 1207.5 s.

Evaluation of the Patient Effective Dose in Whole Spine Scanography Based on the Automatic Image Pasting Method for Digital Radiography.

BACKGROUND: Whole spine scanography (WSS) is a radiologic examination that requires whole body X-ray exposure. Consequently, the amount of patient radiation exposure is higher than the radiation dose following routine X-ray examination. OBJECTIVES: Several studies have evaluated the patient effective dose (ED) following single exposure film-screen WSS. The objective of this study was to evaluate patient ED during WSS, based on the automatic image pasting method for multiple exposure digital radiography (APMDR). Further, the calculated EDs were compared with the results of previous studies involving single exposure film-screen WSS. PATIENTS AND METHODS: We evaluated the ED of 50 consecutive patients (M:F = 28:22) who underwent WSS using APMDR. The anterior-posterior (AP) and lateral (LAT) projection EDs were evaluated based on the Monte Carlo simulation. RESULTS: Using APMDR, the mean number of exposures was 6.1 for AP and 6.5 for LAT projections. LAT projections required more exposures (6.55%) than AP projections. The mean ED was 0.6276 mSv (AP) and 0.6716 mSv (LAT). The mean ED for LAT projections was 0.6061 mSv in automatic exposure control (AEC) and 0.7694 mSv in manual mode. The relationship between dose-area-product (DAP) and ED revealed a proportional correlation (AP, R(2) = 0.943; LAT, R(2) = 0.773). Compared to prior research involving single exposure screen-film WSS, the patient ED following WSS using APMDR was lower on AP than on LAT projections. CONCLUSION: Despite multiple exposures, ED control is more effective if WSS is performed using APMDR in the AEC mode.

Evaluation of radiation doses in patient and medical staff during endoscopic retrograde cholangiopancreatography procedures.

The radiation exposure dose must be optimised because the hazard resulting from an interventional radiology procedure is long term depending on the patient. The aim of this study was to measure the radiation doses received by the patients and medical staff during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Data were collected during 126 ERCP procedures, including the dose-area product (DAP), entrance dose (ED), effective dose (E), fluoroscopy time (T) and number of digital radiographs (F). The medical staff members each wore a personal thermoluminescence dosemeter to monitor exposure during ERCP procedures. The mean DAP, ED, E and T were 47.06 Gy cm(2), 196.06 mGy, 8.93 mSv, 7.65 min and 9.21 images, respectively. The mean dose to the staff was 0.175 mSv and that to the assistant was 0.069 mSv. The dose to the medical staff was minimal when appropriate protective measures were used. The large variation in the patient doses must be further investigated.

A comparative assessment of entrance surface doses in analogue and digital radiography during common radiographic examinations.

Digital radiography is often performed at a higher dose rate than analogue radiography for image acquisition. The authors measured the Entrance Surface Dose (ESD) of analogue and digital radiography techniques for 14 radiographic examinations from randomly selected medical centres in the central district of Korea. It was that the mean ESD of the digital examinations was 2.84 mGy (range, 0.37-6.38 mGy) and that of the analogue examinations was 1.83 mGy (range, 0.38-4.74 mGy), resulting in a 55.25 % higher ESD for digital technique. Although this survey is not completely representative of Korea, findings of this study indicate a need for closer exposure management in digital radiography to minimise patient dose.

Monte Carlo simulation-based feasibility study of a dose-area product meter built into a collimator for diagnostic X-ray.

According to the International Electro-technical Commission, manufacturers of X-ray equipment should indicate the number of radiation doses to which a patient can be exposed. Dose-area product (DAP) meters are readily available devices that provide dose indices. Collimators are the most commonly employed radiation beam restrictors in X-ray equipment. DAP meters are attached to the lower surface of a collimator. A DAP meter consists of a chamber and electronics. This separation makes it difficult for operators to maintain the accuracy of a DAP meter. Developing a comprehensive system that has a DAP meter in place of a mirror in the collimator would be effective for measuring, recording the dose and maintaining the quality of the DAP meter. This study was conducted through experimental measurements and a simulation. A DAP meter built into a collimator was found to be feasible when its reading was multiplied by a correction factor.