Analysis of the x ray diagnostic structure and equipment in the Leningrad region in 2010-2019

Abstract

Maximal reduction of the patient doses from medical exposure without the loss of diagnostic information can be achieved through justification and optimization of X-ray examinations by establishing and applying diagnostic reference levels (DRLs). Scientific and practical basis for the establishment of DRLs is implemented in all national regulatory documents on the radiation safety in medicine. However, in practice DRLs were developed only within the local regional projects. Starting from 2018, a pilot project on the establishment of the regional DRLs has been implemented in the Leningrad region, which was selected as the region of the Russian Federation with abnormally low patient doses from medical exposure. At the first stage of the project dynamics of the structure of the X-ray diagnostics and X-ray equipment in 2010-2019 was analyzed to identify the regional features of X-ray diagnostics and to select the districts and medical facilities for the detailed data collection and assessment. The study was performed based on the analysis of the data from the radiation hygienic passports of the Leningrad region, regional statistical forms 3-DOZ and F-30. The results of the study indicate that the structure of the X-ray diagnostics in the Leningrad region is dominated by the traditional fluorography and radiography examinations. The contribution of modern highly informative high dose examinations (fluoroscopy, computed tomography, interventional examinations) is extremely low, nuclear medicine examinations are absent. For the last 10 years there were no significant differences in the structure of the X-ray equipment; the majority of X-ray and CT units are less than 10 years in operation. The increase in the number of X-ray examinations in the Leningrad region is associated with more intensive use of the X-ray equipment (increase in the number of X-ray examinations per one X-ray or CT unit). The results of the study allowed selecting districts that are most perspective for the patient dose surveys and implementation of the optimization procedures. These districts (Vsevolozhskiy, Gatchinskiy, Vyborgskiy, Tihvinskiy and Kirishskiy) are associated with the maximal increase in the number of the typical X-ray examinations per capita in the last 3-5 years. Results of the study were used as a base for the development of the design of the patient dose surveys in the medical facilities in the Leningrad region.