Congress:
EuroSafe Imaging 2016
Keywords:
Action 4 - Quality of radiological equipment, Action 3 - Image quality assessment based on clinical indications
Authors:
Y. Kovalenko, S. Miroshnichenko
DOI:
10.1594/esi2016/ESI-0022
Background/Introduction
Today more than 20 million of routine chest examinations are performed in Ukraine annually [1].
More than 60 percent of them are make with the help of film fluorographs (Fig.1-2) the main disadvantages of which are low information content and high effective dose on the patient - 5 times higher comparing to chest radiography.
According to the data received by Grigoriev Institute for Medical Radiology real effective doses on the patients examined with fluorographs,
which reached the end of their service life exceed 1.0 mSv,
whereas with digital radiography they are considerably lower [2].
Furthermore,
in the event of detection of abnormality on the photofluorogram,
the 2D chest radiography is carried out,
and the effective dose on the patient considerably exceeds 1.0 mSv,
i.e.
effective dose limit established by the practice guidelines [3,
4].
Fluorography is used due to the low cost of examination the latter being one order less than the cost of plain chest radiography.
To substitute fluorography with chest radiography more than $20,000,000 should be allocated to routine examinations on an annual basis,
which is obviously impossible considering actual economic situation.
Every year in Ukraine more than 1 million fluoroscopies [1] is carried out despite the fact the quantity of these examinations reduces by ca.
20% every 5 years.
This being said,
less than 40% of tilting tables are equipped with X-ray image intensifier (II).
Considering that today more than 85% of X-ray equipment has reached the end of its service life i.e.
has been in operation for more than 10 years,
it may be suggested that part of the X-ray II is out of service.
Probably this could be one of the reasons of fluoroscopies quantity reduction.
Thus today ca.
60% of the fluoroscopies in Ukraine are carried out without using the X-ray II (Fig.3) this increasing the effective dose on the patient more then tree times.
That is precisely why in Ukraine average effective doses of fluoroscopies reach 12 – 26 mSv.
[2].
Taking into consideration the annual purchase of not more than 100 X-ray equipment units the refit of thousands of X-ray departments with the new equipment is impossible.
For this very reason the modernization of the working X-ray equipment using the novel X-ray technologies is the only realistic way of renewal of X-ray facilities at existing economic conditions.