Assessment of radiation dose to pediatric patients during routine digital chest X-ray procedure in a government medical centre in Asaba, Nigeria pediatric radiation dose during chest x-ray procedures

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Asogwa Chijioke Obiora
Hyacienth Uche Chiegwu
Akintayo Daniel Omojola
Ebube Mmeli Onwughalu

Abstract

Objective: Radiation dose to pediatric patients have been widely reported, it is however necessary that imaging expert keep doses as low as possible to forestall stall long term cancer risk. This study is aimed at determining pediatric entrance surface dose (ESD), 75th percentile ESD, absorbed dose (D) and effective dose (E) for 0-15 years.


Material and Methods: The study used a digital radiography (DR) unit with a grid system for each chest X-ray. The thermoluminescent dosimeter (TLD) used was encapsulated in transparent nylon, it was then attached to the patient skin (chest wall) and the second was placed directly at the posterior end of it.


Results: The mean ESDs for the 4 age groups were as follows: 0- < 1 (1.54±0.74mGy), 1- < 5 (1.53±0.83mGy), 5- < 10 (0.55±0.39mGy) and 10- ≤15 (1.30±0.57mGy), with an overall mean of 1.23mGy. The 75th percentile ESD for each age group above 10 patients (excluding 5- < 10yrs) was 2.18, 2.19 and 1.75mGy respectively. The absorbed dose (D) ranged from 0.03-2.39mGy. The mean effective dose (E) for the 4 age groups was 0.18±0.03mSv. There was a good correlation between ESD and D (P = 0.001). A One-Way ANOVA shows that the field size and focus to film distance (FFD) affected the ESD and D (P < 0.001) respectively. The risk of childhood cancer from a single radiograph was of the order of (1.54-23.4) ×10-6.


Conclusion: The 75th percentile ESD, E and childhood risk of cancer was higher than most studies it was compared with. The study reveals that machine parameters such as the field size and FFD played a major role in dose increase. Protocol optimization is currently needed for pediatric patients in the studied facility.

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How to Cite
Obiora, A. C., Chiegwu, H. U., Omojola, A. D., & Onwughalu, E. M. (2021). Assessment of radiation dose to pediatric patients during routine digital chest X-ray procedure in a government medical centre in Asaba, Nigeria. Medical Science and Discovery, 8(3), 155-160. https://doi.org/10.36472/msd.v8i3.493
Section
Research Article
Author Biography

Asogwa Chijioke Obiora, Dept of Radiography and Radiological Sciences, Nnamdi Azikiwe University Awka, Anambra state, Nigeria

Department of Radiography and Radiological Sciences

References

1. Wunderle K, Gill AS. Radiation-related injuries and their management: an update. Semin Intervent Radiol. 2015; 32(2):156-162.

2. Kutanzi KR, Lumen A, Koturbash I, Miousse IR. Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations. Int J Environ Res Public Health. 2016; 13(11):1057.

3. Hong J, Han K, Jung J, Kim JS. Association of exposure to diagnostic low-dose ionizing radiation with risk of cancer among youths in South Korea. JAMA Netw Open. 2019; 2(9):e1910584.

4. Menashe SJ, Iyer RS, Parisi MT, Otto RK, Stanescu AL. Pediatric Chest Radiographs: Common and Less Common Errors. Am J Roentgenol. 2016; 207: 903-911.

5. Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatr Rev. 2014; 35(10):417-429.

6. Andronikou S, Lambert E, Halton J, Hilder L, Crumley I, Lyttle MD, et al. Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents. Pediatr Radiol. 2017; 47(11):1405-1411.

7. Wang MX, Baxi A, Rajderkar D. Pictorial review of non-traumatic thoracic emergencies in the pediatric population. Egypt J Radiol Nucl Med. 2019; 50, 11:13

8. United Nations Scientific Committee on the Effect of Atomic Radiation (UNSCEAR) Report. Volume 1: Sources report to the general Assembly Scientific Annexes A and B. 2008

9. ICRP, (2013). Radiological protection in paediatric diagnostic and interventional radiology. ICRP Publication 121. Ann. ICRP. 2013; 42(2).

10. Reigstad MM, Oldereid NB, Omland AK, Storeng R. Literature review on cancer risk in children born after fertility treatment suggests increased risk of haematological cancers. Acta Paediatr. 2017; 106(5):698-709.

11. Johnson KJ, Lee JM, Ahsan K, Padda H, Feng Q, Partap S, et al. Pediatric cancer risk in association with birth defects: A systematic review. PLoS ONE. 2017; 12(7): e0181246.

12. Paquette K, Coltin H, Boivin A, Amre D, Nuyt A-M, Luu TM. Cancer risk in children and young adults born preterm: A systematic review and meta-analysis. PLoS ONE. 2019; 14(1): e0210366.

13. ICRP, (2007): The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP. 2007

14. ICRP, 1991. Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP 21; 1990: (1-3)

15. IAEA. Diagnostic Radiology: An international Code of Practice. Technical Report Series No. 457, International Atomic Energy Agency, Vienna. 2007

16. ICRU. Patient Dosimetry for x rays used in medical imaging. ICRU Report 74. ICRU. 2005 5(2).

17. European Union. European Commission. Directorate-General XII-Science R, Development. European guidelines on quality criteria for diagnostic radiographic images in paediatrics: Office for Official Publications of the European Communities; 1996.

18. Omojola AD, Akpochafor MO, Adeneye SO. Calibration of MTS N (LiF: Mg, Ti) chips using cesium 137 source at low doses for personnel dosimetry in diagnostic radiology. Radiat Prot Environ 2020; 43:108-114.

19. ACR–AAPM–SPR. Practice parameter for diagnostic reference levels and achievable doses in medical x-ray imaging. Reference Levels and Achievable Dose (diagnostic). Revised 2018 (Resolution 40)

20. National Council on Radiation Protection and Measurement. Reference levels and achievable doses in medical and dental imaging: recommendations for the United States. Bethesda, Md. NCRP Report No. 172; 2012.

21. Mohamadain, KEM, Azevedo ACP, Da Rosa LAR, Mota HC, Goncalves OD, Guebel, MRN. Entrance skin dose measurements for paediatric chest x-rays examinations in Brazil. 2 Ibero-Latinamerican and Caribbean Congress of Medical Physics, Venezuela. 2001

22. Egbe NO, Inyang SO, Ibeagwa OB, Chiaghanam NO. Pediatric radiography entrance doses for some routine procedures in three hospitals within eastern Nigeria. J Med Phys. 2008; 33(1): 29–34.

23. Olgar T, Onal E, Bor D, Okumus N, Atalay Y, Turkyilmaz C et al. Radiation Exposure to Premature Infants in a Neonatal Intensive Care Unit in Turkey. Korean J Radiol. 2008; 9(5): 416-419.

24. Alatts NO, Abukhiar AA. Radiation doses from chest X-ray examinations for pediatrics in some hospitals of Khartoum State. Sudan Med Monit 2013; 8:186-8.

25. Mesfin Z, Elias K, Melkamu B. Assessment of Pediatrics Radiation Dose from Routine X-Ray Examination at Radiology Department of Jimma University Specialized Hospital, Southwest Ethiopia. J Health Sci 2017; 27(5):481.

26. Wall BF, Haylock R, Jensen JTM, Hillier MC, Hart D, Shirmpton PC. Radiation risks from medical X-ray examination as a function of age and sex of the patient. Chilton, Didcot, HPA-CRCE-028, UK. 2011

27. Vilar-Palop J. Updated effective doses in radiology. J Radiol Prot. 2016: 36 975

28. Aliasgharzadeh A, Shahbazi-Gahrouei D, Aminolroayaei F. Radiation cancer risk from doses to newborn infants hospitalized in neonatal intensive care units in children hospitals of Isfahan province. Int J Radiat Res. 2018; 16: 117-122

29. Armpilia CI, Fife IAJ, Croasdale PL. Radiation doses to neonates and issues of radiation protection in a special care baby unit. IAEA-CN-85-52. 556-560 1993