Increasing Radiation Doses from Computed Tomography versus Diagnostic Reference Levels: How Compliance Are We?

Aim: To assess the radiation dose received in a clinical/real life setting by patients visiting selected radiological centres in Enugu, Enugu State, southeast of Nigeria for diagnostic computed tomography (CT) scans of the heads and thus assess compliance to the diagnostic reference levels (DRL).

Study Design: A prospective cross-sectional survey design.

Place and Duration of Study: CT Units of University of Nigeria Teaching Hospital, Memfys Hospital for Neurosurgery and Conquest Medical Imaging Limited in Enugu, Enugu State, Nigeria between April 2012 and January 2013.

Materials and Method: Radiation doses absorbed by 98 patients (60 males and 38 females, age range 3-65years) that presented for CT scans of the head at the study centres were prospectively measured using lithium fluoride thermoluminescent dosimeter, LiF-TLD (TLD-100) chips. The mean absorbed dose, mean effective dose, collective dose and the per caput dose with their standard deviations were obtained.

Results: The mean absorbed dose was 4.315 ± 3.815mSv (range 1.005-17.607mSv) and the mean effective dose was 2.244±1.984 mSv. In children (0-15years) the mean absorbed dose was 5.604±4.904mSv and mean effective dose, 2.914±2.278 mSv and these doses were higher than that of the adults. The annual collective dose was 224.40±198.4 person-mSv and the annual per caput dose was 5.9 x 10-7mSv. The calculated mean organ effective doses were 0.147±0.056mSv, 0.884±0.334mSv, 0.147±0.056mSv, 0.3540±0.134mSv and 0.147±0.056mSv for the brain, eye lenses, thyroid gland, red bone marrow and breast respectively.

Conclusion: TLD chip were used to assess patients’ radiation dose in a clinical setting. The overall mean effective dose (2.244mSv) was in compliance with the recommended DRL. The radiation dose received correlated positively with the tube current (mA) and number of images obtained but negatively with the scan time, patients’ head AP dimension and age. Radiation risks from CT can be reduced through justification of the procedure and dose optimization.