Patient Dose Assessment During Radiological Examination: Case of the Vakinankaratra and Haute Matsiatra Regions of Madagascar

The medical use of ionizing radiation is the largest and a growing man-made source of radiation exposure. The aim of this study is to assess the doses received by patients during radiological examinations in order to standardize the examination procedures and optimize the patient dose. Four most frequented hospitals, located in the Vakinankaratra and Haute Matsiatra regions of Madagascar, were investigated. Patients dose undergoing chest posterior-anterior (PA) and lateral (LAT), skull (PA, LAT), lumbar spine (PA, LAT), spine cervical (PA, LAT), abdomen (AP, LAT) and members (AP, PA, LAT) X-ray examinations were involved in this study. Entrance Skin Dose (ESD) was calculated using the X-ray radiation output and the exposure parameters (high voltage, tube loading, focus-patient distance). Thermoluminescent dosimeters were used to measure the X-rays radiation output. Conversion coefficients were used to relate ESD to the effective dose (ED). A total of 302 radiographic examinations were collected from the four hospitals during two months of 2019. The highest ESD (mGy) was found for the lumbar spine lateral projection, with an average value of 2.66 mGy. The highest value of ED was observed for the abdomen lateral projection with an average of 0.174 mSv. The ESDs and EDs reported in this study are generally lower than reference dose values published by the IAEA. This trend is an indication that the patient radiation protection practices in these four hospitals are already acceptable. The results of this study showed that there is a need to improve the radiodiagnostic procedures for reducing patient radiation dose without affecting the quality of the radiography image. The data of this work will be useful in contributing to the formulation of regional guidance levels.