Radiation Safety of Patients in Diagnostic Radiology in the Russian Federation: Current Status, Problems and Solutions

The paper presents an analysis of the structure and collective dose of diagnostic Xray examinations in the Russian Federation in 2018-2022 to assess the trends in the development of Russian X-ray diagnostics. The study was performed based on the results of the analysis of federal state statistical observation forms (radiationhygienic passports and form №3-DOZ for the 2018-2022 period). The results of the analysis indicated that the considered time interval can be divided into several periods: pre-pandemic (2018-2019), pandemic (2020-2021) and post-pandemic (2022); each of which had its own features of the structure of X-ray diagnostics and, consequently, the collective dose from medical exposure. During 2018-2022 period collective dose from medical exposure has increased by a factor of 1,5: from 85000 manSv to 134000 manSv, mainly due to computed tomography. The contribution of computed tomography to the collective dose has increased from 54 % in 2018 to 74 % in 2022. The results of analysis of the distributions of average effective doses for the most common Xray procedures indicated that, in contrast to the above-mentioned indicators, the average doses did not change significantly over the period considered. The study allowed identifying regions of the Russian Federation systematically presenting incorrect (underestimated) average effective doses from X-ray examinations. Based on the results of analysis, proposals were developed to improve the system of radiation protection of patients from medical exposure. Successful practical implementation of these proposals will allow obtaining reliable data on patient and staff doses in the Russian Federation and avoiding excessive increase in doses from medical exposure.