Evaluation of diagnostic reference levels (DRL) in pediatric appendicogram examination for radiation safety improvement

Appendicogram examination usually uses fluoroscopy that can increase radiation exposure, especially in children who are more sensitive to the long-term effects of radiation. This study aims to evaluate the effectiveness of applying radiation protection principles to pediatric appendicograms using computed radiography (CR), as well as assess the suitability of exposure parameters with international reference dose limits.This study used a mixed methods design combining qualitative and quantitative research. The study was conducted using parameters of 60 kVp, 20 mAs, 100 cm FFD. The dose values evaluated included ESD, DAP, and ED, which were compared with DRL from BAPETEN, ICRP and European Commission PiDRL. The results showed an average ESD of 2.09 mGy, DAP of 0.31 Gycm2, and ED of 0.046 mSv. 2,089 mGy, which is still within the reference range set by BAPETEN 2-3 mGy for pediatric abdominal examinations.The radiologist's assessment of the visualization of the anatomy indicated that the diagnostic images produced were sufficient to establish a diagnosis on an appendicogram examination.Pediatric appendicogram examination using CR without fluoroscopy with the applied parameters results in a low radiation dose within the DRL limits, with good diagnostic image quality. Optimization is still needed, particularly with reduced mAs to support the ALARA principles.