The use of these imaging system seems to be growing rapidly due to their superiority over screen-film system such as linear dynamic range and digital image acquisition. Radiation doses resulting from X-ray examinations depend on the X-ray imaging technology and the exposure setting employed for recording the images on these imaging devices. In diagnostic radiology, screen-film system is replaced by computed radiography system to incorporate the concept of filmless radiology practice. The ESD values obtained for 21 different X-ray projections are either comparable or lesser than the reported national/international values. The third quartile values of ESDs are established as the institutional DRLs. The lowest ESD ratio is for Hip Lat which is 2.68. The ESD ratio for Chest PA, Knee Lat and Lumbar Spine AP are 30.75, 30.4 and 30.2 respectively. The ratio of measured ESD (maximum to minimum) for these examinations is found to be highest for the cervical spine AP with a value of 50 followed by Thoracic spine AP of 32.36. The lowest contribution comes from Hip Lat which is about 1.01%. The data collected indicates that majorly performed examinations are cervical spine AP, Chest PA and Knee Lat with percentage contributions of 16.05, 16 and 8.27% respectively. Five number summary was calculated for all the data for their presentation in the Box-Whisker plot, which provides the statistical distribution of the data. The ESD for each of these patients were estimated using measured X-ray beam output and the standard value of the back scatter factor.
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For this purpose, patient specific parameters and machine specific parameters (kVp, mAs, distance and field sizes) of 1875 patients during 21 different types of X-ray examinations were recorded for estimating the entrance skin dose (ESD). The change in imaging system requires the re-establishment of the institutional diagnostic reference levels (DRLs) for different types of X-ray examinations conducted at the hospital.
The screen-film system is replaced by computed radiography system for recording the images of the patients during X-ray radiography examinations.
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