Patient dose audit of the most frequent radiographic examinations and the proposed local diagnostic reference levels in southwestern Nigeria: Imperative for dose optimisation

Diagnostic reference levels (DRLs) is a veritable tool for dose optimisation and patient protection in diagnostic radiology. However, it is essential to have information on the local situation especially in a large hospital with several units or a cluster of healthcare centres within a geographical region with several X-ray units. In the present study, entrance surface doses (ESDs) were measured in twelve (12) healthcare centres consisting of 15 radiological units using thermoluminescent dosimeters (TLDs). Seven radiological procedures such as; chest PA, abdomen AP, pelvis AP, lumbar spine AP, skull AP, knee AP, and hand AP frequently carried out in Nigeria were included in the study, and their local diagnostic reference levels (LDRLs) were determined. The values of the determined LDRLs were compared with established NDRLs in UK, US, Slovenia, Italy and Brazil. The LDRLs determined in the two groups (healthcare centres) studied ranged from 1.78 to 3.01, 2.71 to 2.84, 2.11 to 3.79, 3.93 to 8.79, 1.06 to 1.73 and 1.10 to 1.44 mGy for chest PA, pelvis AP, lumbar spine AP, skull AP, knee AP and hand AP respectively. Large variations were found among the X-ray units studied even within the same centre. Entrance surface doses obtained in pelvis AP and lumbar spine AP in both GROUP A and were found to be lower than the NRPB-HPA 2010 review for UK, while in all other five examinations, value of the measured entrance surface dose (ESD) are higher than the doses reported in the UK review. The relative higher doses found in the study are attributable to higher tube load (mAs) used and indicative of the need for dose optimisation in Nigerian radiological practice.