Hysterosalpingography dose assessment with direct digital radiography in a medical facility: A potential high risk procedure to patient in South-South Nigeria

Akintayo Daniel Omojola, Azuka Anthonio Agboje, Kanu Bassey Uche, Michael Onoriode Akpochafor, Samuel Olaolu Adeneye, Eunan Okechukwu Oparaocha, Edwin Ehis Amiegbereta


Background: Hysterosalpingography (HSG) procedures often come with higher dose due to multiple exposures.

Aims: The study was aimed at carrying out a preliminary audit of doses in HSG exams with thermoluminescent dosimeters (TLDs) in a facility using direct digital radiography (DDR), with the aim of identifying parameters that greatly affect the patient dose and see possible ways to optimize them in the future

Methods: The prospective study involved 53 booked female patients for HSG procedures. The study used a ceiling mounted direct digital radiography unit for exposures. Patient was made to lie in a supine position. Two TLD chips (LiF: Mg, Ti) were positioned at the central axis of the beam covering the pelvis to estimate the entrance surface dose (ESD) and another posteriorly to estimate the exit dose (ED). A PCXMC software was used to estimate the effective dose (Eff) and organ doses.

Results: The mean and 75th percentile ESD was 15.94±2.05 and 18.82±6.41 mGy respectively. The number of exposures, dose area product (DAP) and effective dose (Eff) ranged from 5.7 (4-10), 15.85 (5.02-51.07) Gycm2 and 4.6 (1.46-14.8) mSv. The mean dose to the ovaries, uterus and bladder were 4.63 (4.06-5.03) mGy, 6.17 (5.45-6.65) mGy and 10.8 (9.68-11.92) mGy. Estimated cancer risk was 230 (90-740) per million.

Conclusion: The ESD, Eff and organ doses were comparable to studies that used TLDs with conventional radiography; however this study was multiple times higher compared to fluoroscopy modality. Factors that contributed to patient dose were the number of exposure and patient field sizes. Protocol optimization should be considered to reduce patient risk.


Hysterosalpingogram, Organ dose, Thermoluminescent dosimeter, Exposure, Conventional radiography

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DOI: http://dx.doi.org/10.36162/hjr.v8i1.520


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