Assessment of entrance skin dose for adult patients undergoing diagnostic X-ray examinations in the Souss-Massa region of Morocco

Abstract

The objective of this study is to evaluate the Entrance Skin Dose (ESD), and to establish the Diagnostic Reference Levels (DRLs) for the most common X-ray examinations in adult patients in the Souss-Massa region of Morocco. Data from 720 adult patients in four radiology departments in the Souss-Massa region were collected. The data concerned the following examinations: thorax posterior anterior (PA), unprepared abdominal X-ray, pelvis, hip, cervical spine anterior-posterior (AP) and lateral (Lat), lumbar spine anterior-posterior (AP) and lateral (Lat). The following parameters were reported for each examination: age, weight, patient thickness, voltage (kV), electrical charge (mAs), and the skin source distance. The Entrance Skin Dose and the Diagnostic Reference Levels are calculated for each X-ray examination. DRLs in terms of ESD for the same X-ray examination differ widely from one hospital to another. They ranged from 3 to 14 mGy for the unprepared abdominal X-ray, from 2.6 to 9.4 mGy for the pelvis, from 3.1 to 17 mGy for the hip, from 1 to 49.2 mGy for the cervical spine Lat, from 2 to 32.6 mGy for the lumbar spine AP, and from 18.1 to 50 mGy for the lumbar spine Lat. The variation of doses received by patients in the four hospitals calls into question radiological procedures and practices and calls for a standardization of guidelines for each radiological examination.