Measurement of absorbed dose for paediatric patients for the purpose of developing dose guidelines in paediatric radiology

Abstract

The radiation risks associated with children are higher than the risk for adults. Children have growing organs and they have a longer life expectancy than that of adults. As a consequence the effects of damage from radiation could be greater than in adults. Children who receive radiation damage may pass genetic damage onto future generations. This study was carried out to investigate the optimal effective x-ray dose young children need to receive who have radiographic examination to the chest at Tygerberg Hospital, South Africa. Chest radiographs are documented as being the most common radiographic examination done on children. The age groups of children participating in this study were 0-1 year, 1-5 years and 5-10 years. A total of 67 children were involved and the absorbed doses for 134 views of the anterior-posteria (AP) chest and lateral chest were measured. Entrance surface dose (ESD) values were determined, and measured mean ESD (mGy) and the ESD range was reported for each age group. This was done by attaching thermolurninescent dosirneters (TLD pellets) to the patients skin at the entrance point of the x-ray beam. The results were compared to similar studies done in Ireland and Nigeria From the ESD values obtained the absorbed doses ofthe eyes, heart, liver, thyroid and genitals could be calculated by using the "Childdose" programme ofthe NRPB. The ESD dose levels for South Africa compare favourably with Ireland. However the Nigerian values differed greatly from those of Ireland and South Africa It was very encouraging to note the comparative results achieved at Tygerberg Hospital especially due to the fact that this was the first time such study had been conducted in the Tygerberg Hospital Radiology Department. The results also compare favourable with that achieved by a group working in the United Kingdom. This group does similar surveys every five years as part of their radiation protection programme. The results were also in line with the UNSCEAR document of2000. v This study could serve as a valuable source of reference to radiographers and radiologists when performing paediatric radiology especially as the radiation absorbed dose could be used as a baseline to create awareness of size of dose received, and to limit deleterious radiation doses to patients and to prevent unnecessary exposures. A second significant outcome of the study was the effect that added filters had on the x-ray beam generated. Experiments were done in which the filtration filters were added sequentially. It was found that if the filtration was increased to 2mmAl the dose to the patient decreased by more than 20%. At 50 and 60 kV the density of the x-ray image on film only increased by 2%. From these results it may be concluded that an increase in filtration thickness used for paediatric chest x-rays should be giVIng reduced dose readings and assisting with radiation protection ofthe patient.