Establishment of typical doses for the most common procedures in general radiography at the General hospital Celje and comparison with exposure index

Uvod: Pomembno je poznati proces optimizacije delovnih postopkov in preiskav. Izpostavljenost preiskovanca mora biti optimizirana tako, da je prejeta doza tako nizka, kot je razumno dosegljivo pri posameznem diagnostičnem posegu. Izpostavljenost ionizirajočem sevanju preiskovancev (določitev diagnostičnih referenčnih ravni/tipičnih vrednosti dozimetričnih količin) se lahko v splošni radiologiji določi z merjenjem vstopne kožne doze (ESD) ali produktom doze in površine (DAP). Namen: Namen raziskave je retrospektivno analizirati podatke in tako pridobiti vrednosti DAP in ekspozicijskega indeksa pri petih najpogostejših preiskavah splošne radiografije na urgentnem centru v Splošni bolnišnici Celje. Na ta način želimo določiti tipične doze za posamezno preiskavo. Metode dela: Analitične podatke smo pridobili s pomočjo DICOM ključnika iz programa ISSA in BIRPIS iz opravljenih rentgenografskih preiskav v obdobju enega leta (2021) v Splošni bolnišnici Celje. Predmet našega proučevanja so bili preiskovanci, ki so v letu 2021 opravili rentgensko slikanje na urgentnem centru (UC) na dveh rentgenskih aparatih znamke Siemens Ysio (Erlangen, Nemčija). Dobljene DAP vrednosti in vrednosti ekspozicijskega indeksa smo primerjali z vrednostmi iz strokovne literature. Rezultati in razprava: Predlagamo vrednosti tipičnih doz za devet radioloških preiskav in sicer prsnega koša leže (AP projekcija) znaša vrednost 2. kvartila 7,28 µGym2, stoje (PA projekcija) je vrednost 8,89 µGym2, stransko 21,85 µGym2, abdomna leže (AP projekcija) je vrednost 105,83 µGym2, stoje pa 77,87 µGym2, za medenico znašajo 75,27 µGym2 ter kolka 32,81 µGym2. Dobljene vrednosti za ledveno hrbtenico znašajo pri AP projekciji 35,78 µGym2, pri stranski pa 145,71 µGym2. Ugotovili smo, da so določene vrednosti doz 2.kvartila dobljene v naši raziskavi primerljive oz. nižje od tistih iz strokovne literature. Izvedli smo korelacijo med DAP in EI in ugotovili, da je povezava zelo šibka pri projekciji pljuč leže AP (r= -0,050), trebuhu leže (r= 0,087) in ledveni hrbtenici stransko (r= 0,126). Šibko povezavo smo dobili pri pljučih stoje PA (r= -0,283) ter ledveni hrbtenici AP (r= 0,473). Srednjo povezavo pa pri projekciji pljuč stransko (r= 0,583), medenici (r= 0,600), kolku (r= 0,583) in trebuhu stoje (r= 0,621). Zaključek: Z raziskavo smo dobili boljši vpogled v tipične doze za devet radioloških posegov na urgentnem centru v Splošni bolnišnici Celje ter s tem dobro iztočnico za nadaljevanje tovrstnih raziskav in prostor za izboljšave glede optimizacije protokolov.Introduction: It is important to understand the process of optimising work procedures and examinations. The subject’s exposure must be optimised so that the dose received during a specific diagnostic procedure is as low as reasonably achievable. In general radiology, the exposure of subjects to ionising radiation (based on a calculation of diagnostic reference levels/typical values of dosimetric quantities) can be determined by measuring the entrance skin dose (ESD) or dose-area product (DAP). Purpose: The purpose of the study is to retroactively analyse data to extrapolate the DAP values (product of the dosage and surface area) and the exposure index in the five most common general radiography tests at the emergency department of the Celje General Hospital. This allows the typical dosages to be determined for each individual test. Methods: The analytical data were acquired, using the DICOM hashtag from the ISSA and BIRPIS programs, from performed radiographic tests over the period of a year (2021) at the Celje General Hospital. The subjects of our study were patients who underwent X-ray imaging at the emergency department (ED) on two Siemens Ysio X-ray machines (Erlangen, Germany) in 2021. The acquired DAP and EI values were compared with those from the literature. Results and discussion: Nine typical dosage values were proposed for the dosages: the value of the X-ray of the chest in the (AP) supine projection in the 2nd quartile is 7,28 µGym2, in the standing (PA) projection 8,89 µGym2, in the lateral projection 21,85 µGym2, the abdomen in the supine (AP) projection has a DRL value of 105,83 µGym2, in the standing projection 77,87 µGym2, the pelvis 75,27 µGym2 and the hip 32,81 µGym2. The acquired values for the lumbar spine are 35,78 µGym2 in the AP projection and 145,71 µGym2 for the lateral projection. Certain typical dosage values (2nd quartile) acquired in our research were found to be quite comparable to those from the literature. A correlation between DAP and EI was performed, and it was determined that the correlation is very weak for the supine projection of the lungs AP (r= -0.050), the supine stomach (r= 0.087) and the lateral lumbar spine (r= 0.126). A weak correlation was detected for the PA standing projection of the lungs (r=-0.283) and the lumbar spine AP (r= 0.473). A medium correlation was detected for the lateral projection of the lungs (r= 0.583), pelvis (r= 0.600), hip (r= 0.583) and the standing projection of the stomach (r= 0.621). Conclusion: The study provided a better insight into typical doses for nine radiology procedures at the emergency department of the Celje General Hospital, thus giving us a starting point for further similar studies and improvement in protocol optimisation