Measurement of patient entrance surface dose rates for fluoroscopic x-ray units

Measurements of patient entrance surface dose rate provide valuable data for interpreting results from dose-area product studies on fluoroscopic x-ray equipment. Methods for measurement of entrance surface dose rate with backscatter and incident dose rate without backscatter have been investigated. Entrance surface dose rate is measured with an ionization chamber in contact with a tissue-equivalent phantom. Backscattered radiation contributes 27-45% to the measurement and is affected by field size and chamber position. Incident dose rate measured using a copper phantom provides an alternative approach. Consistent relationships between thicknesses of Perspex and copper giving similar incident dose rates under automatic gain control have been established for different tube potentials with and without a grid. This allows measurements of incident dose rate made using copper to be linked to corresponding thicknesses of tissue-equivalent material. Since only a few millimetres of copper are required, contributions from backscatter can be minimized and transport of phantoms is simplified. Incident dose can be related to dose-area product and entrance surface dose derived using backscatter factors. Such measurements play a valuable role in interpreting patient dose data and recommending options to reduce patient dose.