Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil Niveles de referencia diagnósticos para los exámenes radiológicos más frecuentes realizados en Brasil

• Main Authors: Marcelo B. Freitas, Elisabeth M. Yoshimura
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2009
• Subjects: Dosimetría termoluminiscente; radiología; Brasil; Thermoluminescent dosimetry; radiology; Brazil; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Referencia; Chest Head
• Online Access: https://doaj.org/article/91933c9f66674fc5a83285d79d735301

OBJECTIVES: A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in São Paulo (347 radiological exami nations per 1 000 inhabitants), the most populous Brazilian state. METHODS: A postal dosimetric kit with thermoluminescence dosimeters was used to evalu ate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the an nual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were in cluded, and 1 415 values of ESD were measured. RESULTS: The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary lo calizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic ref erence levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. CONCLUSIONS: Despite the reduced number of ESD values and rooms for the pediatric pa tient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out. OBJETIVOS: Estudio a gran escala de las dosis aplicadas a pacientes sometidos a los exámenes radiológicos más frecuentes realizados en los servicios de salud de São Paulo (347 exámenes radiológicos por 1 000 habitantes), el estado más poblado de Brasil. MÉTODOS: Se empleó un sistema dosimétrico postal con dosímetros termoluminiscentes para evaluar la dosis en ...