Radioprotection 2025, 60( 3), 256 – 261 © S. Semghouli et al., Published by EDP Sciences 2025 https:// doi. org / 10.1051 / radiopro / 2024062 Available online at: www. radioprotection. org
ARTICLE
Establishment of local diagnostic reference levels in terms of dose area product( DAP) in conventional radiology at the Regional Hospital Center of Souss Massa, Morocco
S. Semghouli 1,*, M. El Fahssi 2, A. Dahbi 3 and B. Amaoui 4
1 Team Health Techniques( ETechS), Research Laboratory in Health and Environmental Sciences( LabReSSE), Higher Institute of Nursing Professions and Health Techniques( ISPITS), Agadir, Morocco. 2 Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco. 3 Ministry of Health and Social Protection, Higher Institute of Nursing Professions and Health Techniques( ISPITS), Agadir, Morocco. 4 Biotechnology and Medicine( BioMed) Laboratory, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco.
Received: 11 November 2024 / Accepted: 16 December 2024
Abstract – Introduction: The effectiveness of diagnostic reference levels( DRLs) in reducing the doses delivered to patients has been demonstrated. Establishing DRLs in terms of the dose surface product( DSP) is an essential step in the management of radiation doses in conventional radiology. Objective: This retrospective study aimed to assess local diagnostic reference levels( LDRLs) for four types of X-ray examinations in terms of DAP at the Regional Hospital Center of Souss Massa. Materials and methods: Data from 120 adult patients, 30 per location( thorax( PA), pelvis( AP), lumbar spine( AP) and abdomen( AP)) were collected. Patient parameters such as gender, age, BMI, clinical indications, and examination acquisition parameters such as kV, mAs, patient source distance( PSD), and exposure field dimensions were recorded for each patient. The calculation of DRLs is based on a statistical method known as the 75th percentile of the distribution of DAP. The data were statistically analysed by SPSS software V 21.0. Pearson’ s parametric test was used to explore the relationship between the different quantitative variables. Results: The mean ESDs for the thorax( PA), lumbar spine( AP), abdomen( AP), and pelvis( AP) were 0.17, 2.55, 2.16, and 2.63 mGy, respectively. The mean DAP values for the thorax( PA), lumbar spine( AP), abdomen( AP), and pelvis( AP) were 16.53, 213.11, 230.55, and 265.19 cGy. cm2, respectively. The DRLs in terms of ESD for the thorax( PA), lumbar spine( AP), abdomen( AP), and pelvis( AP) were 0.17, 2.77, 2.64, 2.87 mGy, respectively. In terms of DAP, they were 16.58, 245, 291.83, and 300.45 cGy. cm 2, respectively. The results show a significant relationship between DAP and tension, charge, and ESD for all examinations. In addition, there was a significant relationship between DAP and BMI for abdomen X-ray, and no significant relationship for the three other X-ray examinations. Conclusion: It is possible to reduce the dose delivered to patients in the Regional Hospital Center of Souss Massa through the continuous training of radiology workers, implementation of a quality assurance program for equipment, and institutionalization of DRL as an approach to reducing patient doses and health service costs.
Keywords: Conventional radiology / entrance skin dose( ESD) / dose area product( DAP) / Local diagnostic reference levels( LDRLs) / Souss Massa / Morocco
1 Introduction
Ionising radiation has many beneficial applications in a number of fields, including medical diagnosis. However, the risks associated with its use must be assessed and, if necessary, controlled( IAEA, 2014). Medical exposure to ionizing radiation represents the largest contribution to population
* e-mail: ssemghouli @ gmail. com dose from artificial sources, and diagnostic X-rays make up the majority of this contribution( approximately 90 %) due to the increasing number of X-ray examinations carried out each year( IAEA, 2007). In addition, direct epidemiological evidence has been demonstrated linking exposure to ionising radiation to the risk of radiation-induced cancer( ICRP, 1999). In this context, the results of the Life Span Study( 1950 – 1990) showed that 334 of the 7578 people who died of solid tumours could be attributed to exposure to ionising radiation( UNSCEAR, 2000). This situation demonstrates the importance of
This is an Open Access article distributed under the terms of the Creative Commons Attribution License( https:// creativecommons. org / licenses / by / 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.