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Updated: May 17, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Optimisation of patient protection and image quality in diagnostic radiology
G K Korir1, J S Wambani, B O Ochieng
1Department of Physics and Applied Physics, University of Massachusetts Lowell, One University Ave, Lowell, MA 01854, USA.
Objective:
To determine the examination frequencies, quality of radiographic images and the entrance surface dose (ESD) in patients undergoing general radiographic examinations.
Design:
Prospective study on the device performance, film reject rate, patient dose, and image quality during the use of standard and fast speed film screen combination.
Setting:
Radiology Department of Kenyatta National Hospital, a referral, teaching and research hospital in Kenya.
Subjects:
A total of 837 adult and 229 paediatric patients undergoing diagnostic examinations were assessed for patient dose and image quality.
Interventions:
The X-ray tube output measurements and X-ray exposure parameters were determined. The patients ESD on standard 200 and fast 400 speed film screen combination was determined. The radiographic image quality was assessed.
Main Outcome Measures:
The findings were compared with the international diagnostic reference levels (DRL's) for determination of dose optimisation in diagnostic radiography.
Results:
The relative frequency of examination was 80% and 20% for adults and paediatric patients respectively. The image quality improvement by 13% was achieved and patient dose reduction range of 31% to 77%.
Conclusions:
The patient dose reduction and image quality was achieved through a quantitative quality control (QC) assessment of processes involved in producing radiographs. The study leads to the introduction of the concept of plan- do-check-act on QC results and optimise with a view of patient dose reduction. The department appreciated the value of a quality assurance (QA) programme and continues to collect data for establishment of DRL's.
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