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Background Retrospective dosimetric auditing is a useful investigational approach for continuous quality assurance in diagnostic radiography. It may serve as a baseline reference for future research in which both dose and image quality are examined. In radiation protection, comparing diagnostic reference levels (DRLs) with patient doses observed in clinical practice enables the optimization process (i.e., providing a clinically acceptable image quality and keeping the dose as low as reasonably achievable). The purpose of this study was to audit radiation doses of adult patients who underwent common diagnostic x-ray examinations and compare dose area product (DAP) values with the established international DRLs (IDRLs). Methods Retrospective cross-sectional records of 193 patients who underwent 387 radiographic examinations during October through December 2018 were obtained. Patient-related and DAP data were recorded for the six most common examinations with two digital systems of the same manufacturer at King Abdulaziz Medical City in Jeddah (KAMC-JD). The mean and 75th percentile of DAPs was established and compared with IDRLs. The percentage mean and 75th percentile DAP differences were used to describe changes between KAMC-JD values and IDRLs. Results Relative to chest and cervical spine x-rays, wider dispersion and increased variability in DAP values were observed and evidenced by a larger standard deviation for lumbar spine (AP σ=170.29; lateral σ=409.92), thoracic spine (AP σ=43.22; lateral σ=440.44), abdomen (σ=131.62), and pelvis (σ=254.59). Overall, the DAP 75th percentiles for KAMC-JD were below IDRLs for chest, cervical spine, abdomen, and pelvis. Lateral lumber, and AP and lateral thoracic spine DAP 75th percentile exceeded all IDRLs by up to 42.56%, 1.68%, and 512.17%, respectively. When the type of detector is considered, KAMC-JD mean DAPs exceeded the UK 2012 DRLs for the following examinations: AP and lumbar spine (42.83%, 110.8%), AP pelvis (8.06%), AP and lateral cervical (62.86%, 10.71%), and AP and lateral thoracic (36.27%, 355.78%). Conclusion KAMC-JD DAP data were below the international recommendations except for lumbar spine, which exceeded the recommendations. Reassessment after optimizing the lumbar spine DRL is recommended. This study highlights the need for developing local DRLs in Saudi Arabia at the institutional, regional, and national level. |
