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n SA Journal of Radiology - A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital : analysis of preliminary results : review article
Purpose. To retrospectively analyse the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP) readings.
Materials and methods. The subjects of this study were patients who underwent fluoroscopy examinations on either of the two available digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy units at Charlotte Maxeke Johannesburg Academic Hospital during the period August 2007 to March 2008. The skin dose was computed by the system's computer while the DAP values were obtained from a built-in DAP meter installed on the fluoroscopy unit. The following tests were performed : barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram.
Results. An analysis of 331 examinations is presented. The following values were deduced from the recorded data : 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 was a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered shows that fluoroscopic examinations stand to gain from dose optimisation. The usefulness and potential use of DAP meters for dose optimisation in radiology are shown. In line with efforts to optimise the 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.
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