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February 26, 2026Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging0 citationsOpen Access

Comparative Dosimetric Analysis of System Displayed versus Calculated Entrance Skin Dose in Routine Radiographic Imaging

AKAbhishek KumarSBShuchi BhattAMAtul Mishra

Key Points

  • This research aims to assess the accuracy of entrance skin dose values displayed on digital X-ray machines compared to estimated values during routine radiographic procedures.
  • Evaluated entrance skin dose for 250 radiographs from 150 patients across five common views.
  • Estimated ESD values calculated using a specific formula and compared to values displayed on digital consoles.
  • Performed statistical analysis to assess correlation between estimated and displayed values.
  • Mean estimated ESD values varied across radiographic views, indicating discrepancies with displayed values.
  • Strong correlation found between estimated and displayed ESD values (p < 0.001).
  • Intraclass correlation coefficients indicated moderate to strong agreement (62.60 to 84.30%).

Abstract

Abstract X-ray examinations are integral to medical diagnostics but pose risks from ionizing radiation. Adhering to the ALARA (as low as reasonably achievable) principle in diagnostic radiography is essential. This study evaluates the accuracy and reliability of entrance skin dose (ESD) values displayed on digital radiographic X-ray machine by comparing them with estimated ESD values during common radiographic examinations. ESD was estimated for 250 radiographs of 150 patients (90 females, 60 males) undergoing five common radiographic views: lumbosacral (LS) spine anterior–posterior (AP)/lateral (LAT), pelvis AP, and abdomen supine/erect. Using the formula, estimated ESD values were calculated and compared with displayed ESD values from the console of the digital X-ray machine. The mean estimated and displayed ESD values were: LS spine AP (1.31 mGy, 0.92 mGy), LS spine LAT (2.12 mGy, 1.63 mGy), pelvis AP (0.69 mGy, 0.62 mGy), abdomen supine (0.67 mGy, 0.65 mGy), and abdomen erect (1.44 mGy, 1.06 mGy). Statistical analysis revealed a significant correlation between estimated and displayed ESD values across all views (p <0.001). The intraclass correlation coefficient ranged from 62.60 to 84.30%, indicating moderate to strong agreement. These findings were compared with studies from Canada, India, and the UK. Displayed ESD values showed significant deviation from the independently estimated ESD values, indicating that console-generated estimates provide only an approximate indication of patient exposure. Therefore, they should not be considered a precise substitute for direct dosimetric measurements. Reliable ESD values displayed on radiographic equipment facilitate effective radiation protection measures. Incorporating regular ESD monitoring into clinical practice can enhance patient safety and adherence to radiation safety protocols in diagnostic radiology.

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Cite This Study

Kumar et al. (2026) studied this question.

synapsesocial.com/papers/699fe35995ddcd3a253e7252https://doi.org/10.1055/s-0046-1817157
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