engleski

Comparison of dose indicators for radiography between two hospitals in R.N. Macedonia and Croatia

Purpose/Objective Despite technological advances in other imaging techniques, number of diagnostic X-ray examinations is increasing every year. Even though the stochastic risk of low doses of ionizing radiation is very small, each exposure to ionizing radiation requires to be justified and optimized in terms of benefits and risks. The diagnostic reference level (DRL) represents an efficient guideline for optimization of radiographic procedures. The aim of this study was to carry out assessment of patient exposure during radiography procedures and to compare values from two large national hospitals in Republic of North Macedonia and Croatia. Material/Methods Dose area product (DAP) was recorded for the following procedures: lumbar spine anterio-posterior (AP), lumbar spine lateral (LAT), pelvis AP, cervical spine AP, cervical spine LAT, thoracic spine AP and abdomen PA. Data was analyzed using STATISTICA (StatSoft, Inc). Local diagnostic reference levels (DRL) in terms of DAP were calculated as medians for each procedure of both involved institutions as recommended in the latest ICRP 135 Publication. This is also a method for dealing with the lack of patient mass information. Student t-test was used to determine whether the difference between institutions is statistically significant. Results Calculated median DAP values for radiography procedures are given in Table 1. Statistical analyses showed that the difference in terms of DAP between institutions is statistically significant (p < 0.05) for all investigated procedures, except for lumbar spine AP (p=0.679). Conclusion Median values for both institutions are below European DRLs. However, DAP values in the institution 1 (Croatia) are significantly lower than in institution 2 (R.N.Macedonia). The results of this study will be used as a motivation for image quality criteria and exposure technique revision and optimization in both institutions. DRLs are a useful tool in the optimization process which can contribute to improvement in quality of diagnostic procedures. Until this time DRL values are not established for radiography nor for any X-ray examination in the Republic of North Macedonia and this study could present a good basis for their development. On the other hand, University hospital Rijeka has a well-established QA programme and the quality of radiology service in this institution is recognized on an international level. Also, regional cooperation has been one of the goals over the past few years in order to ensure vertical and horizontal exchange of knowledge. Cooperation and comparison within region between EU and non-EU countries is essential in the development of safe, responsible and optimized use of ionizing radiation for medical purposes.

diagnostic reference level, optimisation

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