Measurement of entrance skin dose and estimation of organ dose during pediatric chest radiography

Entrance skin dose (ESD) was measured to calculate the organ doses from the anteroposterior (AP) and posteroanterior (PA) chest x-ray projections for pediatric patients in an Indian hospital. High sensitivity tissue-equivalent thermoluminescent dosimeters (TLD, LiF: Mg, Cu, P chips) were used for measuring entrance skin dose. The respective organ doses were calculated using the Monte Carlo method (MCNP 3.1) to simulate the examination set-up and a three-dimensional mathematical phantom for representing an average 5-y-old Indian child. Using this method, conversion coefficients were derived for translating the measured ESD to organ doses. The average measured ESDs for the chest AP and PA projections were 0.305 mGy and 0.171 mGy, respectively. The average calculated organ doses in the AP and the PA projections were 0.196 and 0.086 mSv for the thyroid, 0.167 and 0.045 mSv for the trachea, 0.078 and 0.043 mSv for the lungs, 0.110 and 0.013 mSv for the liver, 0.002 and 0.016 mSv for the bone marrow, 0.024 and 0.002 mSv for the kidneys, and 0.109 and 0.023 mSv for the heart, respectively. The ESD and organ doses can be reduced significantly with the proper radiological technique. According to these results, the chest PA projection should be preferred over the AP projection in pediatric patients. The estimated organ doses for the chest AP and PA projections can be used for the estimation of the associated risk.