Mean Glandular Dose Measurement in Three Mammography Centers in Kashan: An approach to Provide a Local DRL

Purpose: Mammography is the most important diagnostic modality for early detection of breast cancer, however, concerns related to the side effects induced by ionizing radiation are still present. In the current study, the Mean Glandular Dose (MGD) values for mammography examinations as well as a local Diagnostic Reference Level (DRL) were obtained for mammography centers in Kashan, Iran. Materials and Methods: Three mammography devices from three radiology centers were selected to obtain the MGD values of mammography examinations. To assess the MGD values, the technical parameters for patients’ imaging at these three radiology centers were extracted. Then, the incident air kerma (in mGy) value received by each patient was measured by a UNIDOS E electrometer (PTW, Germany) along with a SFD mammography ionization chamber (PTW, Germany). Finally, the incident air kerma values were converted to the MGD values by specific conversion factors. Based on the obtained MGD values, a local DRL was also established for mammography examinations. Results: Mean MGD values per exposure were obtained 2.39 ± 1.46 mGy for Right Craniocaudal (RCC), 2.64 ± 1.67 mGy for Left Craniocaudal (LCC), 2.82 ± 1.89 mGy for Right Mediolateral Oblique (RMLO), and 3.09 ± 1.90 mGy for left mediolateral oblique views. Moreover, a local DRL obtained from mammography examinations, which was established as the overall median of MGD value, was 1.72 mGy (1.91 mGy for digital and 1.32 mGy for analog mammography). Conclusion: The MGD values for different views obtained in this study are in the range of previously reported values. Considering the European guidelines for quality assurance in breast cancer screening and diagnosis, it can be mentioned that the obtained DRL was less than the recommended dose level (2.0 mGy).

Analisis Nilai Diagnostic Reference Level (DRL) Dewasa Pemeriksaan Lumbal Spine Anterior-Posterior (AP) dan Lateral (LAT) Modalitas Radiografi Umum di Indonesia Berdasarkan Database Dosis Pasien Si-INTAN

Diagnostic Reference Level (DRL) is a tool for optimizing radiation protection for patients. DRL is also applied to the general radiographic modality of the Anterior-Posterior (AP) and Lateral (LAT) lumbar spine examination. This study aims to determine and analyze provincial and national DRL values that are useful as a reference for general radiographic examination of the Lumbar Spine AP and LAT. Using Si-INTAN secondary data starting with grouping and eliminating ESAK values, determining the national body mass reference, calculating the second quartile value (Q2) for local DRL, and third quartile (Q3) for provincial and national. National DRL on this result was also compared regarding DRL in previous studies. The results of this study indicate the DRL values of several provinces in Indonesia on general radiographic examination of the lumbar spine (AP and LAT), namely Banten 4.31 mGy and 7.88 mGy, DKI Jakarta 6.13 mGy and 5.40 mGy, Jambi 1.88 mGy, West Java 2.54 mGy and 4.18 mGy, Central Java 3.25 mGy and 5.81 mGy, Riau Islands 4.19 mGy and 6.78 mGy, Riau 4.31 mGy and 5.90 mGy, Sulawesi Central 2.15 mGy and 9.57 mGy, North Sumatera 1.04 mGy and 2.90 mGy, and national 4.31 mGy and 7.05 mGy. The difference in DRL values is influenced by exposure parameters, the expertise of related human resources, and the patient’s body mass.

Best Practice Keselamatan Radiasi di Rumah Sakit Hermina Karawang

Radiation safety is an action taken to protect workers, community members, and the environment from radiation hazards. The purpose of writing is to realize the best practice of radiation safety culture at Hermina Hospital Karawang. This descriptive study conducted interviews, observations, discussions, and direct measurements from 2020 to 2021. Using the Thermoluminescence Dosemeter (TLD) badge for radiation workers in 2020, 80% of all radiation workers used the TLD badge, and 20% did not because officers forgot and limited use when working in the covid room area. Radiation danger signs have been posted at all examination doors and radiology registration windows. Radiologists always turn on the lights every time they do an X-ray examination. All radiology employees at Hermina Hospital have performed routine health checks at least once a year. The test results of the apron pass fit for use; there is no visible damage in the form of tears, waves, or other damage. The results of the radiation exposure test in the conventional radiology room in the operator's room were 0.063µSv/h, behind the operator's door 0.143 Sv/h, in the administration room 0.087 Sv/h, at the radiology entrance 0.057 Sv/h, the medical gas room and parking area of 0.029 Sv/h and 0.08 Sv/h. The results of radiation exposure test in the area for the CT Scan, namely in the operator's room of 0.046 Sv/h, behind the operator's door 0.118 Sv/h, the entrance to the CT Scan room 0.204 Sv/h, in the poly room and parking area of 0.125 Sv/h, and 0.041 Sv/ h. The results of the exposure test were declared safe from radiation leakage. Radiation Protection Officer (RPO) Hermina Karawang Hospital has participated in online PPR requalification in 2021. The local Diagnostic Reference Level (DRL) value of Hermina Karawang Hospital for non-contrast head CT, namely with CTDIvol = 38.26 mGy and DLP = 777.29 mGy.cm. The implementation of radiation safety best practices at Hermina Hospital has been carried out routinely following applicable regulations regarding radiation safety. It takes consistency and high discipline for radiation workers and hospital management in maintaining the quality of hospital radiation safety. Keywords: Radiation safety, best practice, Diagnostic Reference Level (DRL)