H. Khajmi et al.: Radioprotection 2026, 61( 2), 126 – 131 129
Table 2. The calculated entrance surface dose( ESD) for all projections and examinations. Radiography Projection ESD( mGy)
|
Mean |
Median |
50th percentiles |
75th percentiles |
Cervical spine( AP) |
1.35 |
1.52 |
1.04 |
2.1 |
Cervical spine( LAT) |
1.69 |
1.46 |
0.83 |
1.8 |
Lumbar spine( AP) |
3.09 |
3.34 |
3.15 |
3.7 |
Lumbar spine( LAT) |
4.59 |
4.76 |
3.68 |
5.9 |
Abdomen( AP) |
1.44 |
1.56 |
1.25 |
1.9 |
Pelvic( AP) |
1.68 |
1.98 |
1.74 |
2.35 |
Shoulder( AP) |
1.2 |
1.25 |
1.01 |
1.5 |
Knee( AP) |
0.53 |
0.58 |
0.47 |
0.7 |
Knee( LAT) |
0.57 |
0.58 |
0.5 |
0.65 |
Skull( AP) |
1.77 |
2.2 |
1.29 |
2.9 |
Skull( LAT) |
1.96 |
2.1 |
1.57 |
2.7 |
Chest( PA) |
0.24 |
0.22 |
0.15 |
0.25 |
Table 3. Comparison of the TDRL result of each examination with the relevant ESD( mGy) literature.
Examinations Projection
This study |
French 2013 |
EC 2014 |
UK 2016 |
Nigeria 2017 |
Iran |
|
|
|
|
|
2020 |
Cervical spine( AP) |
1.52 |
4 |
4 |
– |
0.62 |
1.6 |
0.3 |
Cervical spine( LAT) |
1.46 |
4 |
7 |
- |
0.79 |
1.7 |
0.3 |
Lumbar spine( AP) |
3.34 |
10 |
5 |
5.7 |
1.22 |
5.3 |
1.6 |
Lumbar spine( LAT) |
4.76 |
25 |
8 |
10 |
1.59 |
11.8 |
3.1 |
Abdomen( AP) |
1.56 |
8 |
3 |
4 |
1.01 |
4.3 |
1.3 |
Pelvic( AP) |
1.98 |
9 |
4 |
4 |
0.82 |
3.2 |
0.9 |
Shoulder( AP) |
1.25 |
- |
0.7 |
0.5 |
0.71 |
- |
- |
Knee( AP) |
0.58 |
- |
0.4 |
0.3 |
0.5 |
- |
- |
Knee( LAT) |
0.58 |
- |
0.7 |
0.3 |
0.91 |
- |
- |
Skull( AP) |
2.2 |
3 |
0.7 |
1.8 |
1.02 |
2.2 |
0.7 |
Skull( LAT) |
2.1 |
5 |
1 |
1.1 |
1.01 |
2.4 |
0.6 |
Chest( PA) |
0.22 |
0.3 |
0.3 |
0.15 |
0.59 |
1.4 |
0.3 |
Ghana 2023 resulting in a higher dose to the patients. The exposure is directly proportional to the mAs parameter, and the scattered radiation will increase with a larger field and impose more surface doses. The focal spot-to-surface distance( FSD) factor could also affect radiation exposure to patients. The operator’ s selection of settings, as outlined above, is a pivotal factor in determining the absorbed dose. The expertise and dedication of the operator in utilizing appropriate settings can significantly influence the outcome. Reducing patient dose while maintaining image quality is achievable through routine staff training.
4 International comparison of DRLs
Table 3 shows the comparison of established typical diagnostic reference level values for radiographic examination with data from France in 2013( Roch et al., 2013), the European Commission in 2014( EC, 2014), the United Kingdom in 2016( UK, 2016), Nigeria in 2017( Joseph et al., 2017), Iran in 2020( Hoseini et al., 2020), and Ghana in 2023( Gyan et al., 2023).
The typical DRL value for the AP / LAT cervical spine of( 1.52 mGy / 1.46 mGy) was found to be higher than the values recorded in Nigeria of( 0.62 mGy / 0.79 mGy) and Ghana of( 0.3 mGy / 0.3 mGy) but lower than those of Iran of( 1.6 mGy / 1.7 mGy), France of( 4 mGy / 4 mGy), and EC of( 4 mGy / 7 mGy).
The median value of ESD for the AP / LAT lumbar spine of( 3.34 mGy / 4.76 mGy) in this analysis was lower than that seen in France of( 10 mGy / 25 mGy), in EC of( 5 mGy / 8mGy), in theUK of( 5.7 mGy / 10 mGy), and in Iran of( 5.3 mGy / 11.8 mGy). However, it exceeds the registered DRL in Nigeria( 1.22 mGy / 1.59 mGy) and Ghana( 1.6 mGy / 3.1 mGy). This discrepancy can be attributed to the radiography techniques employed.
The established typical DRL values for abdominal and pelvic X-ray AP projection of 1.56 mGy – 1.98 mGy were observed to be considerably lower than the values recorded values in France of 8 mGy – 9 mGy, EC of 3 mGy – 4 mGy, UK of 4 mGy – 4 mGy, and Iran of 4.3 mGy – 3.2 mGy, but higher when compared to Nigeria of 1.01 mGy – 0.82 mGy and Ghana of 1.3 mGy – 0.92 mGy. This could generally be linked to the technology used.