Assessment Of Radiation Dose Reduction To Patients During Barium Series Fluoroscopy Procedures

Abstract

The current reference dose and dose reduction techniques have been assessed during barium series procedures at the Greater Accra Regional Hospital. The study used the kerma area product (KAP) meter fitted on the collimator of the GE fluoroscopy machine to estimate entrance surface doses of patients. The study focused on 120 patients undergoing barium swallow, barium enema and barium meal procedures. This was because previous studies in this area have proposed further dose optimization in barium enema procedure in particular. The self-consistent performance of the fluoroscopy machine was checked using the Piranha and Ocean quality control kit prior to data collection. Patient demographics (such as height, weight and age) and examination parameters (such as tube voltage, screening time, number of radiographs taken and beam projection angle) were collected for the estimation of organ doses using the PCXMC, a computational Monte Carlo based program. The mean KAP readings for barium swallow, barium meal and barium enema examination were 42.01, 4.56 and 9.53 mGy.cm2 respectively. The patient effective dose for barium swallow, barium meal and barium enema examinations were 1.55, 1.94 and 0.43 mSv respectively. The breast (4.72 mGy), stomach (3.54 mGy) and gonads (0.95 mGy) received the highest dose for barium swallow, barium meal and barium enema examinations respectively. Barium swallow was found not to be optimized when the KAP values of this study were compared with previous studies. Further analysis on barium swallow examinations revealed that number of radiographs taken and screening time influences the KAP values. Also, body mass index and KAP values influences the organ doses. Therefore, a relationship between number of radiographs taken, screening time, body mass index and KAP readings was proposed for implementation at the Hospital to enhance dose reduction. Further studies into other factors influencing patient doses is recommended to enhance patient dose optimization at the hospital.