Answer to Question #708 Submitted to "Ask the Experts"
Category: Medical and Dental Patient Issues — Diagnostic X Ray and CT
The following question was answered by an expert in the appropriate field:
Q
Do you know a source or Web site where I can find a listing of typical whole-body doses for common nuclear medicine, radiography, CT, mammo, and fluoro exams? I'm just looking for average doses.
A
There are numerous sources for some of this information. While that is nice for those of us who know where to look, there really isn't one source of information on doses for all types of typical exams. I've put together, in the tables below, some of the information you requested. I've also included the references I used in the event you might want to go to the library to look at them or to order a copy for yourself. Table 1 is a list of x-ray exams and I've given a single-film effective dose.
Table 1. Effective doses for single x-ray films
| Single radiographs |
Effective Dose (mrem) |
| Skull (PA or AP)1 |
3 |
| Skull (lateral)1 |
1 |
| Chest (PA)1 |
2 |
| Chest (lateral)1 |
4 |
| Chest (PA and lateral)5 |
6 |
| Thoracic spine (AP)1 |
40 |
| Thoracic spine (lateral)1 |
30 |
| Lumbar spine (AP)1 |
70 |
| Lumbar spine (lateral)1 |
30 |
| Abdomen (AP)1 |
70 |
| Abdomen6 |
53 |
| Pelvis (AP)1 |
70 |
| Pelvis or hips6 |
83 |
| Bitewing dental film6 |
0.4 |
| Limbs and joints6 |
6 |
Table 2 shows the dose an individual might receive if undergoing an entire procedure, e.g., a lumbar spine series typically consists of five films.
Table 2. Effective doses for complete x-ray procedures
| Complete exams |
Effective Dose (mrem) |
| Intravenous Pyelogram (kidneys, 6 films)1 |
250 |
| Barium swallow (24 images, 106 sec fluoroscopy)1 |
150 |
| Barium meal (11 images, 121 sec fluoroscopy)1 |
300 |
| Barium follow-up (4 images, 78 sec fluoroscopy)1 |
300 |
| Barium enema (10 images, 137 sec fluoroscopy)1 |
700 |
| CT head1 |
200 |
| CT chest1 |
800 |
| CT abdomen1 |
1,000 |
| CT pelvis1 |
1,000 |
| CT (head or chest)5 |
1,110 |
| PTCA (heart study)6 |
750 - 5,700 |
| Coronary angiogram6 |
460 - 1,580 |
| Mammogram6 |
13 |
| Lumbar spine series6 |
180 |
| Thoracic spine series6 |
140 |
| Cervical spine series6 |
27 |
Table 3 gives examples of typical nuclear medicine procedures.
Table 3. Effective doses for routine nuclear medicine studies
| Nuclear Medical Scan |
Activity (mCi) |
Radiopharmaceutical |
Effective Dose (mrem) |
| Brain2 |
20 |
99m+Tc DTPA |
650 |
| Brain3 |
50 |
15O water |
170 |
| Brain4 |
20 |
99mTc HMPAO |
690 |
| Hepatobiliary2 |
5 |
99mTc SCO |
370 |
| Bone2 |
20 |
99mTc MDP |
440 |
| Lung Perfusion/Ventilation2 |
5 & 10 |
99mTc MAA & 133Xe |
150 |
| Kidney2 |
20 |
99mTc DTPA |
310 |
| Kidney3 |
20 |
99mTc MAG3 |
520 |
| Tumor2 |
3 |
67Ga |
1,220 |
| Heart3 |
30 |
99mTc sestimibi |
890 |
| 30 |
99mTc pertechnetate |
1,440 |
| Heart4 |
2 |
201Tl chloride |
1,700 |
| 30 |
99mTc tetrofosmin |
845 |
| Various3 |
10 |
18F FDG |
700 |
References:
- Wall BF, Hart D. Revised radiation doses for typical x-ray examinations. The British Journal of Radiology 70: 437-439; 1997. (5,000 patient dose measurements from 375 hospitals)
- National Council on Radiation Protection and Measurements. Exposure of the U.S. population from diagnostic medical radiation. Bethesda, MD: National Council on Radiation Protection and Measurements; NCRP Report 100; 1989.
- International Commission on Radiation Protection. Radiation dose to patients from radiopharmaceuticals: addendum to ICRP 53. New York, NY: Pergamon Press; ICRP Publication 80; 1999.
- International Commission on Radiation Protection. Radiological protection in biomedical research. New York, NY: Pergamon Press; ICRP Publication 62; 1993.
- National Council on Radiation Protection and Measurements. Sources and magnitude of occupational and public exposures from nuclear medicine procedures. Bethesda, MD: National Council on Radiation Protection and Measurements; NCRP Report 124; 1996.
- United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation, Vol. 1: Sources. New York, NY: United Nations Publishing; 2000.
Kelly Classic
Certified Medical Health Physicst
Answer posted on 30 March 2001. The information and material posted on this Web site is intended as general reference information only. Specific facts and circumstances may alter the concepts and applications of materials and information described herein. The information provided is not a substitute for professional advice and should not be relied upon in the absence of such professional advice specific to whatever facts and circumstances are presented in any given situation. Answers are correct at the time they are posted on the Web site. Be advised that over time, some requirements could change, new data could be made available, or Internet links could change. For answers that have been posted for several months or longer, please check the current status of the posted information prior to using the responses for specific applications.
