Review Article

A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital: Analysis of preliminary results

T Nyathi, M L Pule, P Segone, D G van der Merwe, S P Rapoho
South African Journal of Radiology | Vol 13, No 2 | a541 | DOI: https://doi.org/10.4102/sajr.v13i2.541 | © 2009 T Nyathi, M L Pule, P Segone, D G van der Merwe, S P Rapoho | This work is licensed under CC Attribution 4.0
Submitted: 25 February 2009 | Published: 15 June 2009

About the author(s)

T Nyathi, University of the Witwatersrand
M L Pule, Charlotte Maxeke Johannesburg Academic Hospital, South Africa
P Segone, Charlotte Maxeke Johannesburg Academic Hospital, South Africa
D G van der Merwe, Charlotte Maxeke Johannesburg Academic Hospital, South Africa
S P Rapoho, Charlotte Maxeke Johannesburg Academic Hospital, South Africa

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Abstract

Purpose: To retrospectively analyze the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP). Materials and Methods: The subjects of this study were patients who underwent fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital, South Africa during the period August 2007 to March 2008. The skin dose and dose-area product values were obtained from a built-in DAP-meter installed on a digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy unit. The following cases were analyzed namely barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram. Results: An analysis of three hundred and thirty one examinations is presented. From the recorded data the following quantities were deduced: the mean- and range of the skin doses and DAPs, mean screening time and mean fluoroscopy duration. An analysis of the screening time for the various examinations showed a weak correlation (r = 0.59) between skin dose and screening time, while a poor correlation (r = 0.42) was deduced between DAP reading and screening time. Conclusion: There is a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered proves that fluoroscopic examinations stand to gain from dose optimization. The usefulness and potential use of DAP meters with regards to dose optimization in radiology is shown. In line with efforts to optimize dose from diagnostic radiography examinations the authors recommend the establishment of diagnostic reference levels (DRLs) in South Africa for the most frequent examinations in general radiography, fluoroscopy, mammography and computed tomography. Keywords: patient dose, genetic risk, dose optimization, dose reference levels

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Radiology

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