(MSc. Thesis)

Student: Ahlam Issa
Supervisor: Dr. Adnan Lahham
Jerusalem – Palestine


A b s t r a c t

The need for using medical examinations is increasing around the world, particularly in diagnostics. One specific country that has shown an increase in the use of radiation in medicine is Palestine. This rapid increase in Palestine is accompanied with a lack of information about the radiation dose received by patients. Moreover, there is a lack of quality control, which should be under taken to get better diagnostic information with minimal X-ray exposure. This study attempts to investigate patient dose and establish the diagnostic reference levels (DRLs) of patients' doses for the chest radiography in Palestine. The main focus within this study is to investigate and analyze the factors that affect patient radiation doses from chest radiography in Palestine, which is estimated as 53% of the total number of conventional X-ray examinations. The evaluation of patients dosage and the associated risk factors were done using Monte Carlo simulations. The average effective dose was calculated in four major facilities in Palestine for a total of 668 patients. The first is Al – Makassed hospital in Jerusalem; the second and third are located in Hebron; the forth is a digital center in Jerusalem. The effective dose was measured for a computed radiography (CR) machine at the latter. Patients were selected randomly from November 2014 to February 2015. All calculations were conducted by two commercial Monte Carlo simulation softwares: PCXMC- and Cal-Dose_X5.0. The average effective dose was estimated using geometric procedure data, which have been performed on patients. Factors considered including patient's height, weight, age , gender, X-ray tube voltage and current ,(Milliampere-second), examinations projections (PA, AP, Lateral), filtration thickness in each X-ray machine, anode angle, focal source distance (FSD), and X-ray beam size. The average effective dose for 668 patients was 0.11 mSv for all chest X-ray examinations and projections in the four hospitals. The average effective dose in AP for adults, PA adult, lateral adult, AP pediatric and PA pediatric were 0.14, 0.07,0.33, 0.09 and mSv respectively. The calculated Population Dose (S) is (72.67 mSv to men) for the people in the West Bank from the conventional chest X-radiography only. The annual average per capita effective dose was about 2 X 10-5 mSv.