Patient dose and associated exposure parameters in pelvic x-ray examinations: dependence on radiographic system

Technological differences between computed radiography (CR) and digital radiography (DR) systems can influence patient doses and exposure parameters in pelvic x-ray examinations. The presence of radiosensitive organs in the pelvic region underscores the need to optimize these parameters for both CR and DR systems. This prospective study aimed to compare the patient doses and exposure parameters for adult patients undergoing pelvic x-ray examinations using CR and DR systems, based on data from Sri Lanka. The study included data from 56 x-ray examinations, with 25 using CR and 31 using DR. Patient demographic characteristics and exposure parameters (kVp: kilovoltage peak, mAs: tube current-exposure time product) were recorded, and patient doses were measured in terms of the kerma-area product (P_KA) using a P_KA meter. Despite similar mean weight and body mass index (BMI), the CR systems showed significantly higher mean kVp (7.4%), mAs (16.4%), and P_KA (29.7%) than the DR systems (CR - kVp: 73.2, mAs: 37.8, P_KA: 2.29 Gy cm²; DR - kVp: 67.8, mAs: 31.6, P_KA: 1.61 Gy cm²). The Mann-Whitney U test revealed statistically significant differences in P_KA and kVp between the CR and DR systems (p < 0.05). Furthermore, even with lower patient weight and BMI, the mean mAs and P_KA in this study were substantially higher than those reported in the literature for both CR and DR systems. These results suggest the need to optimize current mAs settings for the studied hospitals and introduce radiographic system-specific exposure parameters and reference dose levels for pelvic x-ray examinations in order to enhance patient protection.