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Published on: December 31, 2015
Typical Diagnostic Reference Levels of Radiation Exposure on Neonates Under 1 kg in Mobile Chest Imaging in
Ioannis Antonakos1, Matina Patsioti1, Maria-Eleni Zachou1
12nd Department of Radiology, National and Kapodistrian University of Athens, 1st Rimini Str., Chaidari Athens, 12461 Attica, Greece.
Insights
This study establishes typical radiation exposure levels for neonatal chest X-rays in Greece, finding lower values than international standards. Image quality was deemed diagnostic, supporting dose optimization for low-weight infants.
Area of Science:
- Medical Physics
- Radiological Sciences
- Pediatric Imaging
Background:
- Diagnostic Reference Levels (DRLs) are crucial for radiation dose optimization in medical imaging.
- Establishing DRLs for specific, sensitive populations like low-birth-weight neonates is essential.
- Mobile radiography in neonatal intensive care units presents unique challenges for dose management.
Purpose of the Study:
- To determine typical radiation exposure levels (DRLs) for chest radiographs in neonates (<1 kg) using mobile X-ray units.
- To compare these established DRLs with existing international literature values.
- To assess the diagnostic image quality of neonatal chest radiographs for dose optimization.
Main Methods:
- Collected dosimetry data (Dose Area Product, Entrance Surface Dose) and patient demographics from 80 neonatal chest X-rays (<1 kg, <30 days).
- Calculated typical radiation exposure values using the median of DAP and ESD distributions.
- Radiologists evaluated image quality (noise, contrast, sharpness) for diagnostic adequacy.
Main Results:
- Typical Dose Area Product (DAP) was 0.08 dGy·cm², and Entrance Surface Dose (ESD) was 9.87 μGy.
- These typical values are lower than reported international DRLs, attributed to lower patient weight and age.
- Over 80% of radiographs met diagnostic criteria, indicating excellent image quality (noise, contrast, sharpness).
Conclusions:
- This study provides essential typical dose values for a vulnerable neonatal subgroup (<1 kg) in mobile radiography.
- The established DRLs are lower than literature values, suggesting effective dose optimization in the studied population.
- High diagnostic image quality supports the safety and efficacy of current radiation practices for neonatal chest imaging.
Abstract:
The purpose of this study is to determine the typical diagnostic reference levels (DRLs) of radiation exposure values for chest radiographs in neonates (<1 kg) in mobile imaging at a University Hospital in Greece and compare these values with the existing DRL values from the literature. Patient and dosimetry data, including age, sex, weight, tube voltage (kV), tube current (mA), exposure time (s), exposure index of a digital detector (S), and dose area product (DAP) were obtained from a total of 80 chest radiography examinations performed on neonates (<1 kg and <30 days old). All examinations were performed in a single X-ray system, and all data (demographic and dosimetry data) were collected from the PACS of the hospital. Typical radiation exposure values were determined as the median value of DAP and ESD distribution. Afterward, these typical values were compared with DRL values from other countries. Three radiologists reviewed the images to evaluate image quality for dose optimization in neonatal chest radiography. From all examinations, the mean value and standard deviation of DAP was 0.13 ± 0.11 dGy·cm2 (range: 0.01-0.46 dGy·cm2), and ESD was measured at 11.55 ± 4.96 μGy (range: 4.01-30.4 μGy). The typical values in terms of DAP and ESD were estimated to be 0.08 dGy·cm2 and 9.87 μGy, respectively. The results show that the DAP value decreases as the exposure index increases. This study's typical values were lower than the DRLs reported in the literature because our population had lower weight and age. From the subjective evaluation of image quality, it was revealed that the vast majority of radiographs (over 80%) met the criteria for being diagnostic as they received an excellent rating in terms of noise levels, contrast, and sharpness. This study contributes to the recording of typical dose values in a sensitive and rare category of patients (neonates weighing <1 kg) as well as information on the image quality of chest X-rays that were performed in this group.
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