Korean J Radiol.  2012 Oct;13(5):610-617. 10.3348/kjr.2012.13.5.610.

National Survey of Radiation Doses of Pediatric Chest Radiography in Korea: Analysis of the Factors Affecting Radiation Doses

• Kim BH
• Do KH
• Goo HW
• Yang DH
• Oh SY
• Kim HJ
• Lee KY
• Lee JE

• KMID: 1392940
• DOI: http://doi.org/10.3348/kjr.2012.13.5.610

Abstract

OBJECTIVE
To investigate radiation doses in pediatric chest radiography in a national survey and to analyze the factors that affect radiation doses.
MATERIALS AND METHODS
The study was based on the results of 149 chest radiography machines in 135 hospitals nationwide. For each machine, a chest radiograph was obtained by using a phantom representing a 5-year-old child (ATOM(R) dosimetry phantom, model 705-D, CIRS, Norfolk, VA, USA) with each hospital's own protocol. Five glass dosimeters (M-GD352M, Asahi Techno Glass Corporation, Shizuoka, Japan) were horizontally installed at the center of the phantom to measure the dose. Other factors including machine's radiography system, presence of dedicated pediatric radiography machine, presence of an attending pediatric radiologist, and the use of automatic exposure control (AEC) were also evaluated.
RESULTS
The average protocol for pediatric chest radiography examination in Korea was 94.9 peak kilovoltage and 4.30 milliampere second. The mean entrance surface dose (ESD) during a single examination was 140.4 microgray (microGy). The third quartile, median, minimum and maximum value of ESD were 160.8 microGy, 93.4 microGy, 18.8 microGy, and 2334.6 microGy, respectively. There was no significant dose difference between digital and non-digital radiography systems. The use of AEC significantly reduced radiation doses of pediatric chest radiographs (p < 0.001).
CONCLUSION
Our nationwide survey shows that the third quartile, median, and mean ESD for pediatric chest radiograph is 160.8 microGy, 93.4 microGy, and 140.4 microGy, respectively. No significant dose difference is noticed between digital and non-digital radiography systems, and the use of AEC helps significantly reduce radiation doses.

Keyword

Radiation protection; Pediatric chest radiograph; Diagnostic reference level

MeSH Terms

Child, Preschool
Humans
Phantoms, Imaging
*Radiation Dosage
*Radiography, Thoracic
Republic of Korea
Risk Factors

Figure

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  Fig. 1 Dose distribution. A. Distribution of radiation dose and number of machines allocated in each range of dose. B. Radiation dose distribution of machines. Yellow line indicates median value of overall distribution and red line indicates third quartile.

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  Fig. 2 Boxplots comparing radiography system, AEC, dedicated pediatric radiography machines and pediatric radiologists for ESD (µGy). ESD = entrance surface dose, AEC = automatic exposure control

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  Fig. 3 Scattergram of machine's years of operation and ESD (*r = -0.24, p = 0.783). Pearson correlation coefficient. ESD = entrance surface dose

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