A survey of radiation dose associated with pediatric plain-film chest X-ray examinations

Abstract

Background: The effective doses delivered to pediatric patients are not well characterized for many plain-film X-ray examination techniques. The few data available on clinical doses in pediatric radiology are generally outdated because of the changes in X-ray generators and hardware that have taken place over the past decade.

Objective: This survey characterizes X-ray examination techniques and measures effective doses delivered to a phantom representing a 1 year old in order to identify specific examination features that may result in greater than necessary doses to pediatric patients.

Materials and methods: An anthropomorphic phantom representing a 1 year old was developed for use as a survey tool. The phantom incorporates direct reading metal oxide semiconductor field effect transistor (MOSFET) dosimeters that permit the effective dose to be measured for clinical examinations. Seventeen commonly performed examinations were characterized at ten facilities with doses determined for a chest series of exams at each facility.

Results: The survey demonstrates that the effective dose for a given examination can vary by an order of magnitude between institutions. Distributions of examination parameters identified those that are most significant for minimizing patient dose.

Conclusion: Efforts spent to determine pediatric specific radiographic techniques contribute more to effective imaging with low patient doses than utilizing AEC controls or high-frequency generators.