Evaluation of patient exposure with Flat Panel Detector (FPD) in X-ray TV system

The use of flat-panel detector (FPD) systems in TV equipment for gastrointestinal tract examination is increasing. The use of FPD systems is believed to reduce the exposure dose. When our institution changed its TV equipment from an image intensifier (GE;MS90Tj) system to an FPD (Shimadzu;SONIALVISION safire DAR-3500) system, we measured the doses produced and carried out a comparative examination of the extent to which exposure could be reduced. Two TV systems were used. We used an analyzer to measure output waveform, tube voltage, and half-value layer (HVL), and an ionization chamber dosimeter to carry out dose-in-air measurements. Body thickness, number of image acquisitions, and fluoroscopy time are required for the calculation of entrance skin dose (ESD). We therefore measured body thicknesses in 1000 upper gastrointestinal tract (UGI) and barium enemas and obtained average body thicknesses for males and females by age group. Values used for number of image acquisitions and fluoroscopy times were the averages in our institution over a two-year period. When an I.I. system was used, the average ESD during UGI examination were 126.8 mGy fluoroscopy dose and 11.62 mGy imaging dose, for an average total dose of 138.42 mGy per examination. ESD during barium enema averaged 201.73 mGy fluoroscopy dose and 45.2 mGy imaging dose, for an average total dose of 246.92 mGy per examination. When an FPD system was used, the average ESD during UGI examination were 58.71 mGy fluoroscopy dose and 5.72 mGy imaging dose, for an average total dose of 64.43 mGy per examination. ESD during barium enema averaged 112.21 mGy fluoroscopy dose and 24.55 mGy imaging dose, for an average total dose of 136.76 mGy per examination. The use of an FPD system reduced both fluoroscopy dose and imaging dose by 50%. The number of TV systems equipped with FPD in Japan has increased from around 1300 in 2006 to around 1700 in 2007. The use of FPD systems can be expected to increase in future. This will enable major reductions in patient exposure dose. Keywords; FPD, patient exposure, UGI examination, barium enema examination