Survey of Image quality and Patient Dose in Simple Radiographic Examinations in Madagascar: Initial results

The purpose of this study is to survey image quality and patient doses in radiographic examinations and to perform comparisons with the international Diagnostic Reference Levels (DRLs). This study is part of an International Atomic energy Agency (IAEA) project (RAF/9/033) and one public hospital and two private hospitals were selected. The rate of unsatisfactory images and image qualities grade were noted, and causes for poor image quality were investigated. Doses delivered to patients were determined in terms of entrance skin dose (ESD) based on X-ray tube output measurements and X-ray exposure parameters. Corrective actions were taken mainly in terms of field size and exposure parameters adjustment and data were recollected. The image quality was improved up to 35 % in these three hospitals. Results showed that there is a large variation of patient doses for common examination in three hospitals. Patient dose reductions ranging from 2 to 82% were achieved. Comparisons of dose levels with IAEA Guidance Levels (GLs) after implementing corrective actions showed that patient doses are lower than reference levels except for chest exam in two hospitals and skull in one hospital. Actions are under way to extend measurements to a national level in order to establish national GLs. Keywords— Radiography, patient dose, optimization, radiation protection