Assessment of Entrance Surface Air Kerma and Effective Dose for Adult Patients Undergoing Conventional Diagnostic X-Ray Examinations in Selected Hospitals in Ogbomoso, Oyo State, Nigeria

Authors

Keywords:

Entrance Skin Dose, CalDose Software, Diagnostic X-ray, ESAK, Effective Dose

Abstract

Diagnostic x-ray examinations are key part of modern medical imaging, helping doctors to diagnose a range of health conditions. However, these procedures expose patients to ionising radiation, which carries certain risks that need careful management. This study therefore assessed the entrance surface air kerma (ESAK) and effective dose (ED) for 1583 adult patients undergoing seven common diagnostic examinations at three different hospitals in Ogbomoso, Oyo State, Nigeria using CalDose software. The results of the study ranged from 0.67 – 6.78 mGy for ESAK and 0.02 – 0.48 mSv for ED. Among the examinations considered, the lumbar spine produced the highest ESAK values across the three hospitals, for both male and female patients, with an effective dose of 0.44 mSv at X, 0.29 mSv at Y, and 0.48 mSv at Z, while the chest had the lowest dose (X= 0.06, Y = 0.02, Z = 0.02 mSv). The estimated effective doses were within the safe limits set by the International Commission on Radiological Protection. These findings emphasise the need for regular dose audits, careful optimisation of exposure settings, and ongoing staff training to reduce patient radiation exposure while maintaining good diagnostic quality.

Dimensions

Abid, H., Mraity, A., & Al Aseebee, M. K. (2021). Evaluation of entrance surface air kerma in patients during PA chest radiography using CALDose program in Al Najaf Governorate hospitals. J. Phys.: Conf. Ser. 1963 012035. https://doi.org/10.1088/1742-6596/1963/1/012035 DOI: https://doi.org/10.1088/1742-6596/1963/1/012035

Ahmed, N. A., Suliman, I. I., Tsapaki, V., & Rehani, M. M. (2009). Patient dose and image quality evaluation in common radiographic examinations in Sudan. In Dössel, O., & Schlegel, W. C. (Eds.). World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany. IFMBE Proceedings, vol 25/3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03902-7_161 DOI: https://doi.org/10.1007/978-3-642-03902-7_161

Babikir E, Hasan HA, Abdelrazig A, Alkhorayef MA, Manssor E, & Sulieman A. (2015) Radiation dose levels for conventional chest and abdominal X-ray procedures in elected hospitals in Sudan. Radiat Prot Dosimetry, 165(1-4):102-6. https://doi.org/10.1093/rpd/ncv108 DOI: https://doi.org/10.1093/rpd/ncv108

Bonifaz, A. P., Camarena Rodriguez, C. S., & Palma Esparza, R. (2021). Diagnostic reference levels for common X-ray procedures in Peru. Cureus, 13(10), e18566. https://doi.org/10.7759/cureus.18566 DOI: https://doi.org/10.7759/cureus.18566

Brenner, D., & Huda, W. (2008). Effective dose: a useful concept in diagnostic radiology. Radiat Prot Dosimetry, 128(4), 503-508. http://dx.doi.org/10.1093/rpd/ncn056 DOI: https://doi.org/10.1093/rpd/ncn056

Ciraj O, Marković S, & Kosutić D. (2005). First results on patient dose measurements from conventional diagnostic radiology procedures in Serbia and Montenegro. Radiat Prot Dosimetry. 113(3):330-5. https://doi.org/10.1093/rpd/nch469 DOI: https://doi.org/10.1093/rpd/nch469

Dalah, E. Z., Zarooni, M. M. A., Binismail, F. Y., Beevi, H. A., Siraj, M., & Pottybindu, S. (2025). Typical and Local Diagnostic Reference Levels for Chest and Abdomen Radiography Examinations in Dubai Health Sector. Journal of Imaging, 11(1)21. https://doi.org/10.3390/jimaging11010021 DOI: https://doi.org/10.3390/jimaging11010021

Deoknam, Seo, Jang, Seogoo, Kim, Jungmin, Kim, Jungsu, Sung, Dongwook, & Kim, HyunJi (2014). A comparative assessment of entrance surface doses in analogue and digital radiography during common radiographic examinations. Radiation Protection Dosimetry, 158(1), 22e27. https://doi.org/10.1093/rpd/nct189 DOI: https://doi.org/10.1093/rpd/nct189

European Commission (1996). European Guidelines on Quality Criteria for Diagnostic Radiographic Images. Report Eur 16261

European Commission (2018). Radiation Protection No. 185 – European Guidelines on Diagnostic Reference Levels for Paediatric Imaging. Luxembourg: Publications Office of the European Union. https://doi.org/10.1007/s00247-019-04346-z DOI: https://doi.org/10.1007/s00247-019-04346-z

Gholami, M., Maziar, A., Khosravi, H. R., D., Ebranhimzadeh F. & Mayahi, S. (2015). Diagnostic reference levels (DRL) for routine X-ray examinations in Lorestan province, Iran. International Journal of Radiation Research, 13(1), 85–90. https://doi.org/10.7508/ijrr.2015.01.012

Health Information and Quality Authority (HIQA). (2023). Diagnostic reference levels: Guidance on the establishment, use and review of diagnostic reference levels for medical exposure to ionising radiation. HIQA. [https://www.hiqa.ie/sites/default/files/2023-11/Diagnostic-Reference-Levels-Undertaking-guidance-2023.pdfInternational](https://www.hiqa.ie/sites/default/files/2023-11/Diagnostic-Reference-Levels-Undertaking-guidance-2023.pdfInternational).

ICRP 2007 Recommendations of the international commission on radiological protection ICRP Publication 103 (Oxford: Elsevier) Ann. ICRP 37 (2–3)

ICRU 2005 Patient dosimetry for X-rays used in medical imaging ICRU Report No. 74 (Bethesda, MD: International Commission on Radiation Units and Measurements)

International Atomic Energy Agency (2007). Dosimetry in diagnostic radiology: An international code of practice. Technical Reports Series No. 457. Vienna: IAEA.

International Atomic Energy Agency (2023). Diagnostic reference levels in medical imaging. IAEA Radiation Protection of Patients (RPOP) Resources. https://www.iaea.org/resources/rpop/health-professionals/radiology/diagnostic-reference-

International Commission on Radiological Protection (1991). 1990 Recommendations of the International Commission on Radiological Protection (Vol. 21(1-3)): Pergamon Press, Oxford.

International Commission on Radiological Protection (2017). Diagnostic reference levels in medical imaging. ICRP Publication 135. Annals of the ICRP, 46(1). DOI: https://doi.org/10.1177/0146645317717209

Irede, E.L., Aworinde, O.R., Lekan, O.K., Amienghemhen, O. D., Okonkwo, T. P., Onivefu, A. P., & Ifijen, I. H. (2026). Medical imaging: A Critical Review on X-ray Imaging for the Detection of Infection. Biomedical Materials & Devices 4, 1–45. https://doi.org/10.1007/s44174-024-00212-1 DOI: https://doi.org/10.1007/s44174-024-00212-1

Isola G. A., Oni O. M., Orodiran O. T., & Ayanlola P. S. (2016): Evaluation of Entrance Skin Dose for Adult Patients Undergoing Diagnostic X-ray Examination using C-Sharp Software in Some Prominent Hospitals in Oyo State, Nigeria. LAUTECH Journal of Engineering and Technology 10(2): 28 – 35. https://laujet.com/index.php/laujet/article/view/386

Jaschke, W., Schmuth, M., Trianni, A., & Bartal, G. (2017). Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know. Cardiovascular and interventional radiology, 40(8), 1131–1140. https://doi.org/10.1007/s00270-017-1674-5 DOI: https://doi.org/10.1007/s00270-017-1674-5

Keen, C. E. (2008). Global radiation dose higher than necessary (AuntMinnieEurope.com staff writer). https://www.auntminnie.com/clinical-news/article/15587119/global-radiation-dose-higher-than-necessary

Kharita, M. H., Khedr, M. S., & Wannus, K. M. (2010). Survey of patient doses from conventional diagnostic radiographic examinations in Syria. Radiat Prot Dosimetry, 140(2), 163-165. http://dx.doi.org/10.1093/rpd/ncq106 DOI: https://doi.org/10.1093/rpd/ncq106

Khoshdel-Navi, D., Shabestani-Monfared, A., Deevband, M. R., Abdi, R., & Nabahati, M. (2016). Local-reference patient dose evaluation in conventional radiography examinations in Mazandaran, Iran. Journal of Biomedical Physics and Engineering, 6(2), 61–70.

Kim, You-hyun, Choi, Jong-hak, Kim, Chang-kyun, Kim, Jung-min, Kim, Sung-soo, Oh, Yu-whan, et al. (2007). Patient dose measurements in diagnostic radiology procedures in Korea. Radiation Protection Dosimetry, 123(4), 540e545. https://doi.org/10.1093/rpd/ncl501 DOI: https://doi.org/10.1093/rpd/ncl501

Korir G. K., Wambani J. S, & Ochieng B. O. (2010). Optimization of patient protection and image quality in diagnostic radiology. East Afr Med J.87 (3):127-133 https://doi.org/10.4314/eamj.v87i3.62198 DOI: https://doi.org/10.4314/eamj.v87i3.62198

Kramer R., Khoury H. J. & Vieira J. W. (2008). CALDose_X—a software tool for the assessment of organ and tissue absorbed doses, effective dose and cancer risks in diagnostic radiology. Phys. Med. Biol. 53 (2008) 6437–6459. doi:10.1088/0031-9155/53/22/011 DOI: https://doi.org/10.1088/0031-9155/53/22/011

Leng, H., Zhang, Y., Zhang, L., & Liu, Y. (2024). The role of imaging techniques in the diagnosis and treatment of neonatal pneumothorax: A comparative analysis of ultrasound and chest X-ray. International Journal of Radiation Research, 22(2), 489-494. https://doi.org/10.61186/ijrr.22.2.495 DOI: https://doi.org/10.61186/ijrr.22.2.495

Mettler, F. A., Jr., Huda, W., Yoshizumi, T. T., & Mahesh, M. (2008). Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology, 248(1), 254-263. https://doi.org/10.1148/radiol.2481071451 DOI: https://doi.org/10.1148/radiol.2481071451

Ofori K., Gordon S. W., Akrobortu E., Ampene A. A., & Darko E. O. (2014). Estimation of adult patient doses for selected X-ray diagnostic examinations. Journal of Radiation and Applied Sciences. 7(4): 459-462 https://doi.org/10.1016/j.jrras.2014.08.003 DOI: https://doi.org/10.1016/j.jrras.2014.08.003

Ofori, E. K., Antwi, W. K., Scutt, D. N., & Ward, M. (2012). Optimisation of patient radiation protection in pelvic X-ray examination in Ghana. Journal of Applied Clinical Medical Physics, 13(4):3719. https://doi.org/10.1120/jacmp.v13i4.3719 DOI: https://doi.org/10.1120/jacmp.v13i4.3719

Olowookere, C. J., Obed, R. I., Babalola, I. A., & Bello, T. O. (2011). Patient dosimetry during chest, abdomen, skull and neck radiography in southwest Nigeria. Radiography, 17(3), 245–249. https://doi.org/10.1016/j.radi.2010.05.009 DOI: https://doi.org/10.1016/j.radi.2010.05.009

Osei, E. K., and Darko, J. (2013). A survey of organ equivalent and effective doses from diagnostic radiology procedures. ISRN Radiol,, 204346. http://dx.doi.org/10.5402/2013/204346 DOI: https://doi.org/10.5402/2013/204346

Sathiya, K., & Ramachandran, K. (2024). Impacts of radiation on human health: A narrative review. J Radiol Med Imaging, 7(1), 1-4.

Sayah, M.A., Abukonna, A., Husssein, M.A., Alshipli, M., Abdelrhman, I.G. (2025). Assessment of patient entrance surface and effective dose in the skull and thoraco-lumbar X-ray examinations. Electron J Gen Med. 22(3):em649. https://doi.org/10.29333/ejgm/16262 DOI: https://doi.org/10.29333/ejgm/16262

Shahbazi-Gahrouei, D., & Baradaran-Ghahfarokhi, M. (2013). Assessment of entrance surface dose and health risk from common radiology examinations in Iran. Radiat Prot Dosimetry, 154(3), 308-313. http://dx.doi.org/10.1093/rpd/ncs244 DOI: https://doi.org/10.1093/rpd/ncs244

Soulis, P. I., Papavasileiou, P., Bakas, A., Lavdas, E., & Stogiannos, N. (2025). Advancing Exposure Index in Radiology for Optimized Imaging, Accuracy, and Future Innovations. Cureus, 17(3), e80819. https://doi.org/10.7759/cureus.80819 DOI: https://doi.org/10.7759/cureus.80819

Teles, P., Carmen de Sousa, M., Paulo, G., Santos, J., Pascoal, A., Cardoso, G., Vaz, P. (2013). Estimation of the collective dose in the Portuguese population due to medical procedures in 2010. Radiat Prot Dosimetry, 154(4), 446-458. http://dx.doi.org/10.1093/rpd/ncs258 DOI: https://doi.org/10.1093/rpd/ncs258

World Health Organization. (2008). Technical meeting Report. “Global initiative on radiation safety in healthcare settings” 15th to 17th december. WHO Headquarters Geneva. Available for: http://www.who.int/ionizing_radiation/about/GI_TM_Report_2008_Dec.pdf.

Yacoob H. Y., & Mohammed H. A. (2017). Assessment of patients X-ray doses at three government hospitals in Duhok city lacking requirements of effective quality control. Journal of Radiation and Applied Sciences 10(2017) 183-187 http://dx.doi.org/10.1016/j.jrras.2017.04.005 DOI: https://doi.org/10.1016/j.jrras.2017.04.005

Published

2026-04-08

How to Cite

Assessment of Entrance Surface Air Kerma and Effective Dose for Adult Patients Undergoing Conventional Diagnostic X-Ray Examinations in Selected Hospitals in Ogbomoso, Oyo State, Nigeria. (2026). Nigerian Journal of Theoretical and Environmental Physics, 4(1), 64-73. https://doi.org/10.62292/njtep.v4i1.2026.117

Issue

Vol. 4 No. 1 (2026): Nigerian Journal of Theoretical and Environmental Physics - Vol. 4 No. 1

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How to Cite

Assessment of Entrance Surface Air Kerma and Effective Dose for Adult Patients Undergoing Conventional Diagnostic X-Ray Examinations in Selected Hospitals in Ogbomoso, Oyo State, Nigeria. (2026). Nigerian Journal of Theoretical and Environmental Physics, 4(1), 64-73. https://doi.org/10.62292/njtep.v4i1.2026.117

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