Estimation of the conversion coefficients from dose-area product to effective dose for barium meal examinations for adult patients

Fluoroscopic examinations of the upper gastro-intestinal tract and, especially, barium meal examinations, are commonly performed in a majority of hospitals. These examinations are associated both with substantial individual patient doses and contribution to the collective dose from medical exposure. Effective dose estimation for this type of examinations is complicated due to: 1) the necessity to simulate the moving X-ray irradiation field; 2) differences in study structure for the individual patients; 3) subjectivity of the operators; and 4) differences in the X-ray equipment. The aim of the current study was to estimate conversion coefficients from dose-area product to effective dose for barium meal examinations for the over couch and under couch exposure conditions. The study was based on data collected in the X-ray unit of the surgical department of the St-Petersburg Mariinsky hospital. A model of patient exposure during barium meal examination was developed based on the collected data on fluoroscopy protocols and adult patient irradiation geometry. Conversion coefficients were calculated using PCXMC 2.0 software. Complete examinations were converted into a set of typical fluoroscopy phases and X-ray images, specified by the examined anatomical region and the projection of patient exposure. Conversion coefficients from dose-area product to effective dose were calculated for each phase of the examination and for the complete examination. The resulting values of the conversion coefficients are comparable with published data. Variations in the absolute values of the conversion coefficients can be explained by differences in clinical protocols, models for the estimation of the effective dose and parameters of barium meal examinations. The proposed approach for estimation of effective dose considers such important features of fluoroscopic examinations as: 1) non-uniform structure of examination, 2) significant movement of the X-ray tube within a single fluoroscopic phase, and 3) the variety of exposure geometries within complete examination