Survey of posteroanterior chest radiography in The Netherlands: patient dose and image quality.

Council Directive 97/43/Euratom (Medical Exposure Directive) states that member States of the European Union shall promote the establishment and use of diagnostic reference levels for radio-diagnostic examinations. Dose surveys can form the basis for the establishment of diagnostic reference levels. In view of the implementation of the Medical Exposure Directive in the Netherlands, a survey of dose and image quality has been performed for posteroanterior (PA) chest radiography in 2001. In this survey, 25 participants were selected from a list of 175 Dutch hospitals, whereas in a previous PA chest survey (about 10 years ago) participation was voluntary and participants came predominantly from the south-western part of the Netherlands. For conventional screen-film PA chest radiography, the present results for patient dose and image quality are quite similar to those results from the previous survey. The fraction of conventional X-ray systems utilizing lung compensation filters has remained approximately the same. For dedicated digital chest radiography systems, image quality is better than for conventional systems, but doses vary and can assume relatively high values. The results indicate that there are still possibilities for dose reduction, without loss of image quality. The 75 percentile value of the entrance surface dose distribution is approximately 0.13 mGy.