The current study was aimed to estimate the entrance surface air kerma (ESAK, mGy) for adult patients undergoing conventional radiography of Anteroposterior pelvis examination, and finally to establish a local diagnostic reference level (DRL). A total of 500 patients were exposed to diagnostic radiation in four hospitals (coded A, B, C, and D) in Taif and Kharaj city, Saudi Arabia, with different X-ray equipment specifications. Patient demographic data like age (y), body mass index (BMI) in kg/m2 as well as exposure factors and X-ray tube output were recorded. ESAK (mGy) was first calculated using the exposure data and tube output values, then the ESAK values were used to estimate entrance surface dose (ESD). The average BMI was 23.9 kg/m2. The mean tube potential used in A, B, C, and D hospitals and the corresponding estimated ESD were found to be 74.2, 69.8, 73, 76,7 kVp, and 2.54, 2.64, 2.94, 3.03 mGy respectively. The correlation coefficient between ESAK and BMI was found to be 0.98. When compared to computed radiography (CR), the conventional X-ray digital radiography reduces the radiation exposure in pelvic imaging by a factor of 1.18. The third quartile of median proposed a lower than the DRL of the previous studies.
This review explores the establishment of diagnostic reference levels (DRLs) for pediatric brain computed tomography (CT) examinations in Saudi Arabia and compares them with nine other countries. An extensive search strategy was employed across various databases, resulting in the inclusion of 9 studies. The studies included patient-based and phantom-based investigations into DRLs, highlighting variations across age groups and countries. Findings suggest notable differences in CT dose index (CTDI mGy) and dose length product (DLP mGy.cm) values. There was a difference in the classification of age group between Saudi food and drug administration (SFDA) and literature. For the age groups 0-5 years and 6-15 years, the DRLs for the SFDA were as follows: CTDI (28 and 42 mGy) and DLP (482 and 697 mGy cm). The discussion emphasizes the importance of age-specific DRLs to optimize radiation doses while ensuring patient safety and diagnostic efficacy. Recommendations include adopting globally accepted standards for dose optimization and continued research into factors influencing DRL variations. Limitations include varying age groupings among studies and limited access to some relevant literature. Overall, this study underscores the importance of standardizing DRLs for pediatric CT to improve patient care and safety.