Congress:
EuroSafe Imaging 2018
Keywords:
Radiation safety, Plain radiographic studies, Fluoroscopy, CT, Radioprotection / Radiation dose, Musculoskeletal system, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Dosimetric comparison
Authors:
J. Santos, A. Brito, R. B. Guisantes, S. Rodrigues, G. Paulo, F. Caseiro Alves
DOI:
10.1594/esi2018/ESI-0069
Description of activity and work performed
Objective:
The aim of this study was to establish local DRL’s for musculoskeletal in all the image modalities: plain radiography,
computed tomography (CT) and fluoroscopy.
Material and methods:
A retrospective analysis of Digital Imaging and Communications in Medicine (DICOM) headers was performed to analyse Dose Are Product (DAP-mGy.cm2) for radiography and fluoroscopy procedures and Dose Length Product (DLP - mGy.cm) and CT dose index (CTDIvol - mGy) for CT examinations.
The most frequent musculoskeletal examinations were selected: pelvis,
knee and spine (cervical,
dorsal,
lumbar) radiography; dorsal,
lumbar and pelvic CT examinations; lumbar and hip orthopaedic surgeries using fluoroscopy.
Considering the lack of information regarding patient weight and height,
the diameter of the body regions was measured to compare patients submitted to radiography (Figure 1) and CT examinations (Figure 2) and define outliers.
Dose values were analysed in order to establish local DRL’s based on the 75th percentile of the dose values.
The clinical information of all the procedures were also analysed.
Results:
A total of 288 examinations were analysed.
The patient mean age was 58 (±16,38) and 60% of the patients were female.
The clinical information of 47% of the procedures was related to musculoskeletal pain,
24% indicated arthritis,
15% were performed for follow-up and 11% for fracture study.
The dose values for radiography were analysed and compare with other European studies (Figure 3).
Local DRL’s were calculated and compared with international literature for CT examinations (Figure 4).
For fluoroscopy procedures it was possible to obtain dose values for orthopaedic surgery of lumbar column and hip (Figure 5).