An improved method for estimating the entrance exposure in diagnostic radiographic examinations

There is currently a widespread consensus on the importance of monitoring patient radiation exposures during radiographic examinations. Diagnostic facilities under federal jurisdiction already legislate maximum patient exposure limits for various diagnostic radiologic examinations, while an increasing number of state legislatures have instituted such regulations. Compliance requires that institutions be capable of assessing each patient's entrance exposures. A method is proposed that would facilitate the acquisition of such patient exposure information in a relatively straightforward and accurate manner, requiring a minimum number of measurements and access to a suitable programmable calculator. A standardized set of exposure measurements obtained on an accurately calibrated three-phase radiographic unit has been fitted by an analytic function. The average accuracy of the fit between the limits of 40-140 kVp and 2.5- to 6.0-mm aluminum filtration was 0.3%. The concept of linear scaling was employed to allow the analytic function to accurately reproduce the exposure outputs of different radiographic units. Validation experiments on patients indicated that an overall accuracy of 10% can be expected when using well-calibrated radiographic equipment. The method described permits institutions to verify their compliance with federal and/or state regulations and to confirm that their radiation exposures are consistent with national averages.