Sri Dewi Astuty, Aandri, St. Hartina Anwar, Syamsir Dewang, Ayu Hardianti Pratiwi, Ajeng Anggreny Ibrahim, Bannu

DESIGN AND EVALUATION OF ENTRANCE SKIN EXPOSURE USING AN ANSI PHANTOM IN CHEST RADIOGRAPHY

Introduction

Design and evaluation of entrance skin exposure using an ansi phantom in chest radiography. Evaluate Entrance Skin Exposure (ESE) in chest radiography using an ANSI phantom and digital X-ray system. Study various parameters to verify radiation dose received by patients, offering a reliable tool for clinical assessment and dose investigation.

Abstract

Entrance Skin Exposure (ESE) is an indicator of the radiation dose received by a patient during a radiographic examination, which can be verified using an ANSI chest phantom. This phantom is made using acrylic and aluminum plates surrounding the air cavity to represent the thoracic anatomy of an adult patient. Irradiation is performed using a digital radiography system (X-Ray DR) with various parameters such as kV, mAs, phantom thickness (Xphantom), and source-to-detector distance (FFD). The resulting ESE, ESD, and DAP values are recorded and will be verified using patient images. This phantom produces ESE readings of 0.061-0.587 mGy, while ESD values are 0.026-0.909 mGy. The most appropriate DAP values for clinical use are 60 kV (2.26 μGy·m2) and 125 kV (16.8 μGy·m2). These findings demonstrate that the ANSI-based thoracic phantom is a reliable and practical tool for evaluating incoming skin dose in chest radiography. Furthermore, this phantom allows for a systematic investigation of the influence of variations in patient thickness and the presence of intrathoracic air spaces on radiation exposure levels.

Review

This paper presents a timely and relevant study on the design and evaluation of Entrance Skin Exposure (ESE) in chest radiography using a dedicated ANSI-based thoracic phantom. The authors appropriately identify ESE as a crucial indicator of patient radiation dose, making the development of reliable verification tools essential for quality assurance and dose optimization in digital radiography. The methodology involves systematic irradiation of the phantom under varying technical parameters (kV, mAs, phantom thickness, FFD), which is a sound approach to characterize dose performance. The use of an acrylic and aluminum phantom designed to mimic thoracic anatomy offers a practical and reproducible platform for investigating radiation exposure. The study quantifies ESE and ESD values within reasonable ranges (0.061-0.587 mGy for ESE; 0.026-0.909 mGy for ESD) and highlights specific Dose Area Product (DAP) values (60 kV (2.26 μGy·m2) and 125 kV (16.8 μGy·m2)) as potentially most appropriate for clinical use. These findings underscore the phantom's utility as a robust tool for assessing incoming skin dose. Furthermore, the abstract emphasizes the phantom's capability to systematically explore the impact of patient-specific factors, such as varying thickness and intrathoracic air spaces, on radiation exposure levels. This capability is particularly valuable for understanding dose variation across patient populations and informing protocol adjustments. While the abstract establishes the phantom as a reliable and practical evaluation tool, certain aspects would benefit from further elaboration in the full manuscript to enhance its clinical applicability. Specifically, the abstract states that the recorded ESE, ESD, and DAP values "will be verified using patient images," yet no results from this crucial verification step are presented, leaving a gap in demonstrating the phantom's direct correlation to real patient data. Additionally, the justification for deeming certain DAP values "most appropriate for clinical use" is not detailed; clarity on the criteria used (e.g., image quality assessment, comparison to diagnostic reference levels) would significantly strengthen this claim. Addressing these points would provide a more complete picture of the phantom's clinical utility and validate its representativeness for guiding dose optimization strategies in actual patient care.

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