Effective dose in Albanian direct chest fluoroscopy

In the absence of reliable supplies of X-ray film, direct fluoroscopy is st ill extensively used in Albania, with chest radiology a particularly common application. This paper aims to quantify both patient skin dose and the ri sk-related quantity effective dose for direct fluoroscopy units based in se ven different Albanian X-ray departments. A standard Quality Assurance (QA) protocol was used to assess tube potential accuracy, half value layer and X-ray tube output of these units. Three groups of X-ray beam parameters wer e defined from the QA results, covering the range of chest posteroanterior (PA) fluoroscopy technique factors seen during the study. Organ-equivalent doses were then measured for a nominal PA chest fluoroscopy examination usi ng a Rando anthropomorphic phantom loaded with lithium fluoride thermolumin escent dosimeter chips. Normalised organ dose factors are listed for the th ree groups of beam conditions simulated. Using these factors, effective dos e for the seven systems surveyed was found to be between 0.06 and 0.42 mSv for a 20 s PA chest fluoroscopy examination. Mean effective dose for this g roup of systems was 0.22 mSv which is a factor of 13 greater than mean effe ctive dose for film/screen PA chest radiography in the UK, whereas entrance surface dose was a factor of 50 greater than the current EU reference leve l.