Dose-Area Product-to-Effective Dose Conversion Coefficients for Pelvic Radiography Using a Monte Carlo Program.

OBJECTIVE. The purpose of this study was to determine dose-area product-to-effective dose (DAP/E) conversion coefficients for a five-view pelvic radiograph series. DAP/E conversion coefficients may be used for radiation dose optimization when designing institutional protocols for pelvic trauma evaluation. MATERIALS AND METHODS. We conducted a retrospective record review of 25 patients at a level 1 trauma center who had sustained pelvic fractures and required a five-view pelvic radiograph series during workup. E values given in International Commission on Radiological Protection Publication 103 were simulated with a PC-based Monte Carlo program in conjunction with anthropomorphic phantoms adjusted on the basis of patient height and weight. Inputs included tube voltage (in kV), tube filtration (in millimeters of aluminum), anode angle, x-ray beam collimation, geometric distances, and angle of projection for each radiograph in the series. An incident polychromatic x-ray spectrum was generated and matched to the corresponding DAP values of each radiograph, and regression analysis was performed for the DAP/E conversion coefficients. RESULTS.E was strongly correlated with DAP independent from body mass index, with a mean global DAP/E conversion coefficient of 0.0125 mSv/dGy · cm2 for all radiographs (R2 = 0.95). Mean DAP/E conversion coefficients were 0.0133, 0.0110, 0.0143, 0.0113, and 0.0101 mSv/dGy · cm2 for anteroposterior, inlet, outlet, Judet left, and Judet right views, respectively (all R2 ≥ 0.94). CONCLUSION. DAP/E conversion coefficients are provided for a five-view pelvic radiograph series to allow reliable estimation of E. Measurement of cumulative E may affirm protocol design changes for the management of pelvic trauma.