• Journal of the Korean Society of Radiology
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• v.8 no.2
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• pp.81-88
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• 2014

In diagnostic radiology, each part is examined through serial radiography in most cases of general radiography. However, the reality is that, as for diagnostic reference level, measured values have been set up only for AP projection of each part and lateral projection. In the clinical setting, cumulative dose is incurred by serial radiography of patients, and this can make comparison of diagnostic reference level and cumulative exposure dose impossible or can lead to underestimation of diagnostic reference level. In this study, measurement of cumulative dose of serial radiography of each part revealed that when converting entrance surface dose to effective dose in case it is included in the exposure field, cumulative dose measured from a maximum of 38.06% to a minimum of 0.23% of individual dose limitation of the public. Also, when converting entrance surface dose of each part that is not included in the exposure field into effective dose, it measured from a maximum of 5% to a minimum of 0.04% of individual dose limitation of the public. Results of this study show entrance surface dose substantially increases in serial radiography of each part. Therefore, it is deemed that hospitals need to establish diagnostic reference level specifically, and subdivision of radiography orders for patients is also required in order to reduce unnecessary inspections. Moreover, the need of accurate exposure field is emphasized in case of inspection of several parts.

• Journal of the Korean Society of Radiology
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• v.9 no.2
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• pp.109-115
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• 2015

In case of a CT examinations, there is a difference in the distribution of radiation dose from that of general X-ray equipments, and it has been known to cause a great radiation exposure during the examinations. However, owing to its high reliability on the accuracy of a examinations result, its use has increased continuously. In consideration of such a circumstance, the CT equipment, radiation dose during CT examinations, diagnostic reference level, and solutions to reduce radiation dose were mentioned on the basis of previously reported data.

• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.503-510
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• 2016

Even though children are exposed to the same amount of radiation, their effective dose amount is higher than those of adults. Therefore, it is very important to reduce the amount of unnecessary radiation exposure because children have a higher radiosensitivity and a smaller body size than adults. In this study, the proposal to seek ways to reduce the amount of radiation is drawn by comparing and analyzing CT Dose Index(CTDI) on the pediatric head CT which was performed at the Busan regional hospitals, to the national diagnostic reference levels. For this, the pediatric head CT scan was conducted among the CT equipments that were installed in downtown Busan. From 2,043 children 10 years old or less who were referred to the pediatric head CT scan, targeting the 28 CT equipments in the 24 hospitals that transmit dose reports to PACS, were examined retrospectively. As a result, the average value of CTDIvol, computed tomography dose index (CTDI) of infant brain, across the hospital, was 31.18 mGy, with DLP of $444.73mGy{\cdot}cm$, which exceeded the diagnostic reference level. The lower the age, the more management is needed for radiation. However, the reality is that the CT examinations are being conducted with a dose that exceeds the reference level as the age of the aged is exceeded. For this purpose, the study seeks to determine the degree of doses of doses outside the diagnostic reference level and analyze the cause of the excess dose and devise measures to reduce the dose reduction.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.807-812
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• 2018

In this study, we investigated the conditions used in setting the recommendation level of general radiography diagnostic reference and tried to evaluate the effective dose and biological evaluation using PCXMC v2.0 program. As a result based on the effective dose of male in ICRP 60, the highest Pelvis AP was 0.794 mSv. The lowest Chest PA was 0.050 mSv. In the case of ICRP 103, the highest T-Spine AP was 0.906 mSv The lowest Chest PA was 0.052 mSv. For 40 years old male and female adults, effective doses of general radiography were evaluated and even if the medical exposures are not subject to the limit of dose, efforts should be made to reduce the medical exposures of the people by keeping the dose below the recommended amount in order to minimize the probable effect of radiation hazard.

• Journal of radiological science and technology
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• v.44 no.6
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• pp.599-605
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• 2021

The International Electrotechnical Commission (IEC) 62494-1 has defined the exposure index (EI) that have a proportional relationship with the dose incident on the image receptor, and target exposure index (EI_T), deviation index (DI). In this study, an appropriate EI_T for skull radiography was established through the diagnostic reference level (DRL) and changes in DI were confirmed. Entrance surface dose (ESD) and EI were obtained using the computed radiography system displayed the EI as per IEC on console and skull phantom by experiment based on the national average exposure conditions announced in 2012 and 2019. And appropriate EI_T was established by applying the DRL in 2012 and 2019. As a results, the EI_T is changed according to the change in the DRL, and the exposure condition that becomes the ideal DI according to the change in the EI_T also has a difference of about 1.41 times. DRL is recommended to optimize the patient dose, however it is difficult to measure in real time at medical institutions whereas EI and DI are displayed on the console at the same time as exposure. When the EI_T is set based on the DRL and the DI is closed to an ideal value, it is useful as a patient dose management tool. Therefore, when the EI_T is periodically managed along with the revision of the DRLs, the patient dose can be optimized through the EI, EI_T and DI.

• Journal of radiological science and technology
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• v.46 no.2
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• pp.123-129
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• 2023

Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm² and 37.47 Gy·cm² , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm² and 117.51 Gy·cm² respectively. In PCI 43 case, those values were 198.73 Gy·cm² and 120.13 Gy·cm² respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

• Journal of the Korean Society of Radiology
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• v.6 no.4
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• pp.281-290
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• 2012

The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.

• Progress in Medical Physics
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• v.30 no.4
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• pp.75-88
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• 2019

Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.

• Journal of Radiation Industry
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• v.12 no.4
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• pp.365-372
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• 2018

The use of CT examinations is increasing rapidly and radiation dose from CT examinations is much higher than other diagnostic radiography examinations including general radiography and mammography. DRLs used to optimize the radiation dose of patients by diagnostic radiology in each country. The objective of this study was to investigate and to analyze the status of DRLs from CT examinations in domestic and other countries. In other countries, DRLs were set for each age group and each examination considering the medical situation of each country. In Korea, DRLs were set for adults and children in 2017. For adults, DRLs were set for 13 examinations. Reported DLP values were 1119, 297, $472mGy{\cdot}cm$ for head, chest and abdomen pelvis examination, respectively. For children, DRLs were set for head examinations. Reported DLP values were 298 (0~1 years), 404 (2~5 years), 494 (6~10 years), 1,088 (11~15 years) $mGy{\cdot}cm$. DRLs of Korea were similar to other countries for head examinations. For chest examinations and abdomen pelvis examinations were relatively lower than other countries. As a major reason for relatively low radiation dose, it is considered to contribute the activity and management of medical radiation safety at national level.

• Journal of Radiation Protection and Research
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• v.35 no.3
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• pp.111-116
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• 2010

Ionizing radiation is most widely used for X-Ray examination among all artificial radiation exposure, it takes up the largest proportion. Even in Korea, the medical exposure by diagnostic X-Ray examination takes up 17.4% of all radiation exposure. It takes up 92% even in artificial radiation exposure. There were 111,567 cases X-Ray radiography for skull diagnosis in 2007, which is 3% annual increase since 2004. Thus, It is need to establish the diagnostic reference level and the medical facilities as a diagnostic reference level to optimize radiation protection of the patients and to reduce the doses of X-ray. In this paper, we survey patient dose on skull radiography - collected from 114 medical facilities nationwide by using human phantom and glass dosimeter. When the patient dose for the skull radiography was measured and evaluated to establish the diagnostic reference level, 2.23 mGy was established for posterior-anterior imaging and 1.87 mGy for lateral imaging was established. The posterior-anterior skull radiography entrance surface dose of 2.23 is less than the guidance level of 5 mGy from the global organizations such as World Health Organization (WHO) and International Atomic Energy Agency (IAEA), and 1.87 mGy for the lateral skull imaging is less than the guidance level of 3 mGy, which is guided by the global organizations such as World Health Organization (WHO) and International Atomic Energy Agency (IAEA).