H. Khajmi et al.: Radioprotection 2026, 61( 2), 126 – 131 127
Table 1. Number of radiography projections, minimum, maximum, mean values of tube potential( kV), tube current( mAs), and exposure time( ms) of technical parameters for studied radiographic examinations.
Radiography Projection Number of radiographies kV mAs Exposure time( ms)
|
|
Min-Max-Mean |
Min-Max-Mean |
Min-Max-Mean |
Cervical spine( AP) |
52 |
55-70-64 |
3-12-9 |
7-38-25 |
Cervical spine( LAT) |
51 |
57-77-68 |
1-50-13 |
2-126-31 |
Lumbar spine( AP) |
52 |
57-77-70 |
10-33-22 |
13-39-24 |
Lumbar spine( LAT) |
53 |
60-90-76 |
5-80-28 |
6-208-37 |
Abdomen( AP) |
160 |
57-85-75 |
4-113-26 |
4-116-29 |
Pelvic( AP) |
85 |
50-85-72 |
3-40-18 |
3-43-20 |
Shoulder( AP) |
50 |
50-77-68 |
1-85-17 |
1-70-21 |
Knee( AP) |
115 |
44-85-61 |
1-8-5 |
4-56-30 |
Knee( LAT) |
115 |
48-85-64 |
1-6-5 |
1-10-9 |
Skull( AP) |
50 |
60-77-73 |
8-16-15 |
9-19-16 |
Skull( LAT) |
51 |
48-80-73 |
3-22-14 |
9-27-17 |
Chest( PA) |
336 |
70-125-94 |
1-13-3 |
2-17-7 |
Many organizations, including the ICRP( 2017), IAEA( 2007), and EC( 2014), as well as several countries such as Germany( 2010), Lithuania( Ziliukas et al., 2010), the UK( Hart et al., 2012), Greece( Metaxas et al.,( 2019)), France( IRSN 2020), Iran( Mohsenzadeh et al., 2020), and Saudi Arabia( Alrehily, 2022), have been involved in establishing DRLs for diagnostic imaging. In recent years, the concept of DRLs has gained significant interest and importance in Morocco. As a result, several studies have been conducted to determine the DRLs in computed tomography( CT) and in both conventional and interventional radiology( Benmessaoud et al., 2021; El Mansouri et al., 2022; Talbi et al., 2022; Benamar et al., 2023; Khajmi et al., 2023).
The Marrakech-Safi region has a large number of radiology departments. These facilities are equipped to perform a range of imaging procedures and to provide essential medical imaging services to the local population; however, no dosimetric investigation has been carried out to analyze the X-ray doses administered in the region’ s radiology departments.
This research was performed to evaluate the exposure parameters selected for radiographic examinations of adult patients and to estimate the entrance surface dose delivered to patients undergoing common diagnostic radiographic projections in the conventional radiology department of the Arrazi Hospital at the Med VI UHC in Marrakech, Morocco. Additionally, we aim to propose typical DRLs values for general radiography examinations. The outcomes of this study will contribute to the limited information currently available on radiation doses to adult patients from medical radiography in Morocco. The results will help clinicians understand the importance of using DRLs as a valuable tool for managing radiation doses in diagnostic radiology and will serve as a basis for further research.
2 Materials and methods
2.1 Patient exams and dosimetric calculations
This study was conducted prospectively. Picture Archiving and Communication Systems( PACS) were utilized to collect, store, and categorize data for each examination on a computer using a Microsoft Excel spreadsheet. The study included 1170 radiography exams of adult patients( over 18 yr of age), with radiographs sampled between March and July 2022. In this paper, we focused on patients with an average weight of 70 kg to evaluate the typical dose administered to an average patient. This audit of entrance surface dose estimation excluded patients who weighed less than 60 kg or more than 80 kg. Table 1 shows the number of conventional radiology examinations carried out and the exposure factors involved.
The conventional emergency radiology department at the ARH of Med VI UHC is equipped with a Philips digital tube diagnostic system, which has been in operation since 2016. It uses a flat sensor as an X-ray detector and regular maintenance is carried out to ensure optimal performance and the production of high-quality images, enabling accurate diagnosis and improved patient care. Dose assessment was performed on patients undergoing the eight most common diagnostic radiographs, which include twelve individual projections. These projections cover the following areas: cervical spine( AP / LAT), lumbar spine( AP / LAT), abdomen( AP), pelvis( AP), shoulder( AP), knee( AP / LAT), skull( AP / LAT) and chest( AP). Each radiograph was performed in the same radiology department.
2.2 Dose calculations
The dosimetry of the patients was carried out according to the projection using both the Dose Area Product( DAP) and the Entrance Surface Dose( ESD). The DAP is calculated by multiplying the radiation dose in air by the area of the X-ray field and is measured in mGy. cm 2. This value is computed automatically for each exposure. DAP is used to assess the radiation doses administered to patients. These measurements are routinely displayed on the X-ray console for each examination. The following formula was used to estimate the ESD( Leclet, 2016):
ESD ¼ BSF: DAP IF: