Assessment of Radiation Dose and Protection Practices in Neonatal Radiography in NICUs

Area of Science:

• Medical Physics
• Pediatric Radiology
• Radiation Protection

Background:

• Neonatal radiography is vital in NICUs but poses risks due to ionizing radiation.
• Concerns exist regarding cumulative radiation exposure and long-term health effects in neonates.

Purpose of the Study:

• To quantitatively assess neonatal entrance surface dose (ESD) during radiography in Saudi Arabian NICUs.
• To compare measured doses with international diagnostic reference levels (DRLs).

Main Methods:

• Prospective study of 100 neonates undergoing chest and abdominal radiography using mobile digital x-ray units.
• ESD estimation from technical parameters (kVp, mAs, FSD) using the NRPB method.
• Correlation and regression analyses to identify dose predictors.

Main Results:

• Average ESD was 0.48 mGy (Hospital A) and 0.49 mGy (Hospital B), not significantly different between sites.
• Measured doses were 5-10 times higher than international neonatal DRLs.
• Patient thickness, mAs, and kVp were significant predictors of ESD.

Conclusions:

• Neonatal radiation doses in the studied NICUs are significantly elevated compared to international benchmarks.
• Urgent optimization strategies, including protocol standardization and technical adjustments, are necessary.
• Findings provide baseline data for regional DRLs and future optimization studies in Saudi Arabia.