Radioprotection 2026, 61( 2), 126 – 131 © H. Khajmi et al., Published by EDP Sciences, 2026 https:// doi. org / 10.1051 / radiopro / 2025028
Available online at: www. radioprotection. org
ARTICLE
Estimation of entrance surface dose for radiography examinations in Arrazi Hospital from Mohammed VI University Hospital Center of Marrakech( Morocco)
H. Khajmi 1,*, A. Tounsi 2 and L. Oufni 3
1 Higher Institute of Nursing Professions and Health Technics, Marrakech, Morocco. 2 Environmental, Ecological and Agro-Industrial Engineering Laboratory, University Sultan Moulay Sliman, Béni Mellal, Morocco. 3 Sultan Moulay Sliman University( LICPM), Faculty of Sciences and Techniques, Department of Physics, B. P. 523, 23000 Béni Mellal,
Morocco. Received: 21 December 2024 / Accepted: 24 May 2025
Abstract – Diagnostic Reference Levels( DRLs) are an important tool for radiography and radiological science practice optimization. Assessment of entrance surface doses for patients in digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. This study aims to determine the typical DRLs( TDRL) values based on entrance surface dose( ESD) for routine radiography in Arrazi Hospital at the Mohammed VI University Hospital Centre( ARH Med VI UHC) in Marrakech, Morocco. A total of 1170 radiography examinations( RE) were included. They underwent 13 separate projections in the adult radiology department of the Marrakech-Safi region teaching hospital. The X-ray tube’ s dose area product( DAP) was used to figure out the patient’ s entrance surface dose for the cervical spine anterior-posterior( AP), cervical spine lateral( LAT), lumbar spine AP / LAT, abdomen AP, pelvis AP, shoulder AP, knee AP / LAT, skull AP / LAT, and the chest PA. The TDRL values of ESD for cervical spine AP / LAT, lumbar spine AP / LAT, abdomen AP, pelvis AP, shoulder AP, knee AP / LAT, skull AP / LAT, and chest AP were 1.52 mGy / 1.46 mGy, 3.34 mGy / 4.76 mGy, 1.56 mGy, 1.98 mGy, 1.25 mGy, 0.58 mGy / 0.58 mGy, 2.2 mGy / 2.1 mGy, and 0.22 mGy, respectively. We compared our TDRL values with those of other countries. Although the estimated TDRLs are encouraging, significant efforts are needed to reduce them, particularly for shoulder, knee, and skull X-rays.
Keywords: Conventional radiology / dose / radiation protection / DAP / ESD / DRL / TDRL
1 Introduction
According to research conducted by the United Nations Scientific Committee on the Effects of Atomic Radiation( UNSCEAR, 2000), approximately 4 to 5 billion X-ray examinations are performed worldwide each year. No other imaging technique is utilized on such a large scale. These exams can provide radiologists with efficient diagnostic capabilities for various diseases and at a lower cost. Although the radiation doses from these examinations are generally low and late effects are expected to be minimal, it’ s important to ensure that the exposures are justified and optimized in relation to their benefits and risks.
The radiation dose received by a patient during an X-ray examination depends on several factors, including tube
* Corresponding author: khajmi. hassan @ gmail. com current, beam voltage, exposure time, the type of X-ray generator used, and the image receptors. Additionally, the patient dose is significantly affected by technician-specific variables and the procedures employed in radiography. Surveys conducted at national and international levels indicate that the patient dose can vary greatly between different patients and X-ray facilities for the same type of X-ray projection. Therefore, it is crucial to assess the patient dose in any diagnostic X-ray facility( Ciraj et al., 2005; Hart et al., 2009; Roch P. et al., 2013).
To minimize the risks associated with radiation exposure, it is essential to reduce the dose received by patients. This can be achieved through various measures, including quality control of facilities and radiological procedures, as well as the establishment of diagnostic reference levels. The concept of DRLs was introduced by the International Commission on Radiological Protection( ICRP) and the European Commission( EC)( ICRP, 1996; EC, 1999). DRLs were created to promote the optimization of radiation exposure for patients.
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