Abstract
Patient dose is usually estimated for a single radiographic projection or computed tomography (CT) series. In this study, patient dose was calculated for predefined clinical indications (24 radiography, 11 CT). Members of the radiology staff of each of 11 hospitals were trained in dose measurement and calculation techniques. Based on clinical indications participants decided on imaging protocols and calculated cumulative effective dose for a complete examination. Effective dose ranged from <1 μSv to 0.6 mSv for examinations with radiographs and from 0.2 to 12 mSv for CT scans. Differences in the imaging protocols contributedd to a substantial variation in patient dose. For mammography, average glandular dose (AGD) was estimated for 32-, 53- and 90-mm compressed breast thicknesses, with a median value of 0.74, 1.74 and 3.40 mGy, respectively. The results presented here demonstrate that a pragmatic choice of dosimetry methods enables local staff to estimate effective dose. The inclusion of imaging protocols in the dose surveys provided a broader view on the variations in patient dose between hospitals.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
European Union (1997) Council Directive 97/43/Euratom. On health protection of individuals against the dangers of ionizing radiation in relation to medical exposure. Luxembourg
Staatsblad van het Koninkrijk der Nederlanden, Besluit Stralenbescherming, 16 juli 2001, Stb. 2001, 397
CT dose calculator ImpactDose, VAMP GmbH, Erlangen Germany. Internet: http://www.vamp-gmbh.de/software/impactdose.php
ImPACT (Imaging Performance Assessment of CT) group. CTdosimetry.xls spreadsheet can be downloaded from http://www.impactscan.org/ctdosimetry.htm. In this study, version 0.99e was used
Tapiovaara M, Lakkisto M, Servomaa A (1997) PCXMC: A PC-based Monte Carlo program for calculating patient doses in medical x-ray examinations, report STUK-A139, Helsinki: Finnish Centre for Radiation and Nuclear Safety. For information and demo version. see http://www.stuk.fi/pcxmc/
Radiography dose calculator: WinODS, RTI Electronics AB, Mölndal, Sweden. Internet: http://www.rti.se/products_accessories/software.htm
ICRP publication 60 (1991) 1990 Recommendations of the International Commission on Radiological Protection. Pergamon Press, Oxford, UK
Length and weight of the Dutch population, 1998/2000. Statistics Netherlands, Voorburg/Heerlen
European Commission (1999) EUR 16262 – European guidelines on quality criteria for computed tomography. Luxembourg, Office for Official Publications of the European Communities
Dance DR, Skinner CL, Young KC, Becket JR, Kotre CJ (2000) Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol. Phys Med Biol 45:3225–3240
Grøn P, Olerud HM, Einarsson G, Leitz W, Servomaa A, Schoultz BW, Hjardemaal O (2000) A nordic survey of patient doses in diagnostic radiology. Eur Radiol 10:1988–1992
Leitz W, Jönsson H (2001) Patientdoser från röntgenundersökningar I Sverge, sammanställning av resultaten från sjukvårdens rapportering (1999). SSI Rapport 2001–2001. Swedish Radiation Protection Institute, Stockholm
Hart D, Wall BF (2002) Radiation exposure of the UK population from medical and dental X-ray examinations. National Radiological Protection Board publication NRPB-W4, Chilton
Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2005) Doses from computed tomography (CT) examinations in the UK – 2003 review. National Radiological Protection Board publication NRPB-W67, Chilton
Clarke J, Cranley K, Robinson J, Smith PHS, Workman A (2000) Application of draft European Commission reference levels to a regional CT dose survey. Br J Radiol 73:43–50, Jan
Origgi D, Vigorito S, Villa G, Bellomi M, Tosi G (2006) Survey of computed tomography techniques and absorbed dose in Italian hospitals: a comparison between two methods to estimate the dose-length product and the effective dose and to verify fulfilment of the diagnostic reference levels. Eur Radiol 16:227–237, Jan
Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, Galanski M (2003) Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol 13:1979–1991, Aug
Kruger RL, Schueler BA (2001) A survey of clinical factors and patient dose in mammography. Med Phys 28:1449–1454, Jul
Geleijns J, Broerse JJ, Shaw MP, Schultz FW, Teeuwisse W, van Unnik JG, Zoetelief J (1997) Patient dose due to colon examination: dose assessment and results from a survey in The Netherlands. Radiology 204:553–559, Aug
Geleijns J, Broerse JJ, Chandie Shaw MP, Schultz FW, Teeuwisse W, Van Unnik JG, Zoetelief J (1998) A comparison of patient dose for examinations of the upper gastrointestinal tract at 11 conventional and digital X-ray units in The Netherlands. Br J Radiol 71:745–753
Acknowledgements
This project was supported by ZorgOnderzoek Nederland, project no. 1630-0004. The authors would like to thank Bianca Alsemgeest, Marinka van Asselt, Edwin van Harn, Willy Hummel, Matthijs Huttinga, Rinke Kattenberg, Martin Kuikman, Michael Melis, Arjen van der Most, Willem Rasenberg, Kees Roscher, Enouschka Schleurholts, Wouter Stam, Lamberta Wielinga, Nienke vd Zee, Rintje Zijlstra and Luc Zwart for their enthusiastic participation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Teeuwisse, W., Geleijns, J. & Veldkamp, W. An inter-hospital comparison of patient dose based on clinical indications. Eur Radiol 17, 1795–1805 (2007). https://doi.org/10.1007/s00330-006-0473-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-006-0473-1