Compliance of Radiation Dose and Image Quality in a Nigerian Teaching Hospital with the European Guidelines for Pediatric Screen-Film Chest Radiography

Introduction Over the years, the consequences of ionizing radiation have prompted major efforts towards producing radiographs of acceptable quality with dose values in compliance with safety standards and the ALARA principle. The aim of this study is to assess the compliance of radiation dose and image quality in a major Nigerian teaching hospital to the guidelines established by the Commission of European Communities (CEC) on optimized pediatric radiography. Materials and Methods The entrance skin dose (ESD) and image quality were studied among pediatric patients (age range: 0–15 years), referred to the hospital for chest radiographic examinations. Radiographic exposure factors were recorded in each examination. ESD was determined using a dose calculation software program (DoseCal®). The calculated ESD values were weighed against the CEC recommended doses and compared among different age groups through mean comparison. Based on the CEC image quality criteria, the resulting chest radiographs were assessed in terms of image quality. Results The overall image quality was high in over 70% of images (Fleiss’ kappa=0.63). The obtained ESD values were higher than the recommended CEC values (80 and 100 μGy for children aged 0-1 and 5 years, respectively). Also, the ESD values were higher than the recommended values by 26% in the age group of 0–1 year and 9-10% in the other age groups. However, there was no significant difference between the age groups in terms of radiation dose. Conclusion The findings show that a considerable reduction in radiographic exposure factors (or doses) could still produce images with an acceptable diagnostic quality. This dose reduction could be achieved by reducing mAs, increasing kVp and adopting high-performance X-ray generators.