Establishing of a National Diagnostic Reference Level for Radiation Dose in Digital Paediatric Pelvic X-Rays in Jordan: A Multicenter Retrospective Study

Malak AlHawadi, Mohammad Ayasrah Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, JordanCorrespondence: Mohammad Ayasrah, Department of Allied Medical Sciences Faculty of Applied Medical Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan, Tel +96227201000-26939, Fax +96227201087, Email [email protected]: Paediatric pelvic X-rays are essential for diagnosing injuries and developmental abnormalities but pose radiation risks to sensitive children. Dose Reference Levels (DRLs) play a critical role in optimising radiographic procedures, ensuring both safety and high-quality imaging.Objective: This research aimed to establish a National Dose Reference Level (NDRL) for digital paediatric pelvic X-rays in Jordan to optimise radiation doses, improve diagnostic accuracy, and minimise risks.Methods: A Multicenter retrospective analysis was performed on paediatric Anterior-Posterior (AP) digital pelvic X-rays from various 12 Jordanian healthcare institutions. Parameters including Kilovoltage peak (kVp), milli Ampere second (mAs), and Focal to Skin Distance (FSD) were collected. Entrance Surface Dose (ESD) was indirectly calculated following international guidelines.Results: The study analysed 1,674 paediatric pelvic X-rays, finding a mean ESD of 0.69 milli-Gray (mGy). The 75th percentile ESD, or (DRL), was 0.612 mGy overall, with age-specific DRLs of 0.265 mGy (0 to < 1 year), 0.382 mGy (1 to < 5 years), 0.704 mGy (5 to < 10 years), and 0.995 mGy (10 to ≤ 15 years).Conclusion: The study revealed age-dependent variations and notable disparities in radiation doses among various healthcare institutions in Jordan. Establishing the NDRL of 0.612 mGy provides a benchmark for dose optimisation and aligns Jordan’s practices with international standards. The findings can guide national radiation protection policies and clinical guidelines, enhance paediatric imaging practices, and minimise unnecessary radiation exposure.Keywords: radiation safety, paediatric radiography, dose reference levels, DRLs, dose optimisation, medical imaging, Jordan