Erenstein, HG, Browne, D, Curtin, S, Dwyer, RS, Higgins, RN, Hommel, SF, Menzinga, J, Pires Jorge, JA, Sauty, M, de Vries, G and England, A (2020) The validity and reliability of the exposure index as a metric for estimating the radiation dose to the patient. Radiography.

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Abstract

Introduction
With the introduction of digital radiography, the feedback between image quality and over-exposure has been partly lost which in some cases has led to a steady increase in dose. Over the years the introduction of exposure index (EI) has been used to resolve this phenomenon referred to as ‘dose creep’. Even though EI is often vendor specific it is always a related of the radiation exposure to the detector. Due to the nature of this relationship EI can also be used as a patient dose indicator, however this is not widely investigated in literature.

Methods
A total of 420 dose-area-product (DAP) and EI measurements were taken whilst varying kVp, mAs and body habitus on two different anthropomorphic phantoms (pelvis and chest). Using linear regression, the correlation between EI and DAP were examined. Additionally, two separate region of interest (ROI) placements/per phantom where examined in order to research any effect on EI.

Results
When dividing the data into subsets, a strong correlation between EI and DAP was shown with all R-squared values > 0.987. Comparison between the ROI placements showed a significant difference between EIs for both placements.

Conclusion
This research shows a clear relationship between EI and radiation dose which is dependent on a wide variety of factors such as ROI placement, body habitus. In addition, pathology and manufacturer specific EI’s are likely to be of influence as well.

Implications for practice
The combination of DAP and EI might be used as a patient dose indicator. However, the influencing factors as mentioned in the conclusion should be considered and examined before implementation.

Item Type: Article
Additional Information: This is the final published version (version of record). It was first published online via Elsevier at http://www.sciencedirect.com/science/article/pii/S107881742030050X - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Exposure index, Radiation dose, Radiography
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 12 Jun 2020 14:08
Last Modified: 12 Jun 2020 14:22
URI: https://eprints.keele.ac.uk/id/eprint/8177

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