Abstract:
The cervical spine X-ray is the most commonly performed projection X-ray examination
in patients for the initial diagnosis of spinal complaints, tumours, fractures, and
degenerative pathologies. The radiosensitive organs are exposed to significant radiation
doses, which imposes radiation-induced risks to the patients. The Diagnostic Reference
Levels (DRLs) can be used as an effective optimisation tool in such instances. This study
aimed to estimate the kerma-area product (KAP) of adult patients for the cervical spine
(anteroposterior-AP and lateral-LAT) examinations and to compare the obtained patient
doses with the DRLs published in countries: United Kingdom (UK), Ireland, France,
Greece, India, Iran, and Australia. This descriptive cross-sectional study was conducted
in a provincial hospital in Sri Lanka with 63 adult patients weighing between 38 and
78 kg. The patient characteristics (age, weight, height) and corresponding exposure
parameters (tube voltage, tube current-exposure time product) were obtained. The
KAP values were measured, and descriptive statistics were utilised for data analysis.
The median KAP values were 0.23 and 0.19 Gy.cm2
for the cervical spine AP and LAT
examinations, respectively. Compared to published DRLs, the percentage difference
in median KAP for cervical spine AP examinations was 109% higher than Australia’s
local DRLs (LDRLs), but 43% lower than France’s national DRLs (NDRLs). Also, the
median KAP for LAT examinations was 27% higher than the NDRLs of the UK and
the LDRLs of Australia but 53% lower than the NDRLs of France. The median KAP
values for cervical spine LAT examinations were comparable with Ireland’s NDRLs and
significantly lower than the DRLs of France, Greece, India, and Iran. The overall results
show that the cervical spine LAT examinations were more comparable to those of other
countries than the AP examinations. This recommends further dose optimisation for the
cervical spine AP examination.
