TY  - JOUR
AU  - Vassileva, Jenia
AU  - Rehani, Madan M.
AU  - Al-Dhuhli, Humoud
AU  - Al-Naemi, Huda M.
AU  - Al-Suwaidi, Jamila Salem
AU  - Appelgate, Kimberly
AU  - Aranđić, Danijela
AU  - Bashier, Einas Hamed Osman
AU  - Beganovic, Adnan
AU  - Benavente, Tony
AU  - Bieganski, Tadeusz
AU  - Dias, Simone
AU  - El-Nachef, Leila
AU  - Faj, Dario
AU  - Gamarra-Sanchez, Mirtha E.
AU  - Garcia-Aguilar, Juan
AU  - Gbelcova, L'ubka
AU  - Gershan, Vesna
AU  - Gershkevitsh, Eduard
AU  - Gruppetta, Edward
AU  - Hustuc, Alexandru
AU  - Ivanović, Sonja
AU  - Jauhari, Arif
AU  - Kharita, Mohammad Hassan
AU  - Kharuzhyk, Siarhei
AU  - Khelassi-Toutaoui, Nadia
AU  - Khosravi, Hamid Reza
AU  - Khoury, Helen
AU  - Kostova-Lefterova, Desislava
AU  - Kralik, Ivana
AU  - Liu, Lantao
AU  - Mazuoliene, Jolanta
AU  - Mora, Patricia
AU  - Muhogora, Wilbroad
AU  - Muthuvelu, Pirunthavany
AU  - Novak, Leos
AU  - Pallewatte, Aruna S.
AU  - Shaaban, Mohamed
AU  - Shelly, Esti
AU  - Stepanyan, Karapet
AU  - Teo, Eu-Leong Harvey J.
AU  - Thelsy, Naw
AU  - Visrutaratna, Pannee
AU  - Zaman, Areesha
AU  - Zontar, Dejan
PY  - 2012
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4810
AB  - OBJECTIVE. The purpose of this study was to assess the frequency of pediatric CT in 40 less-resourced countries and to determine the level of appropriateness in CT use. MATERIALS AND METHODS. Data on the increase in the number of CT examinations during 2007 and 2009 and appropriate use of CT examinations were collected, using standard forms, from 146 CT facilities at 126 hospitals. RESULTS. The lowest frequency of pediatric CT examinations in 2009 was in European facilities (4.3%), and frequencies in Asia (12.2%) and Africa (7.8%) were twice as high. Head CT is the most common CT examination in children, amounting to nearly 75% of all pediatric CT examinations. Although regulations in many countries assign radiologists with the main responsibility of deciding whether a radiologic examination should be performed, in fact, radiologists alone were responsible for only 6.3% of situations. Written referral guidelines for imaging were not available in almost one half of the CT facilities. Appropriateness criteria for CT examinations in children did not always follow guidelines set by agencies, in particular, for patients with accidental head trauma, infants with congenital torticollis, children with possible ventriculoperitoneal shunt malfunction, and young children ( LT 5 years old) with acute sinusitis. In about one third of situations, nonavailability of previous images and records on previously received patient doses have the potential to lead to unnecessary examinations and radiation doses. CONCLUSION. With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.
T2  - American Journal of Roentgenology
T1  - IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness
VL  - 198
IS  - 5
SP  - 1021
EP  - 1031
DO  - 10.2214/AJR.11.7273
ER  - 

@article{
author = "Vassileva, Jenia and Rehani, Madan M. and Al-Dhuhli, Humoud and Al-Naemi, Huda M. and Al-Suwaidi, Jamila Salem and Appelgate, Kimberly and Aranđić, Danijela and Bashier, Einas Hamed Osman and Beganovic, Adnan and Benavente, Tony and Bieganski, Tadeusz and Dias, Simone and El-Nachef, Leila and Faj, Dario and Gamarra-Sanchez, Mirtha E. and Garcia-Aguilar, Juan and Gbelcova, L'ubka and Gershan, Vesna and Gershkevitsh, Eduard and Gruppetta, Edward and Hustuc, Alexandru and Ivanović, Sonja and Jauhari, Arif and Kharita, Mohammad Hassan and Kharuzhyk, Siarhei and Khelassi-Toutaoui, Nadia and Khosravi, Hamid Reza and Khoury, Helen and Kostova-Lefterova, Desislava and Kralik, Ivana and Liu, Lantao and Mazuoliene, Jolanta and Mora, Patricia and Muhogora, Wilbroad and Muthuvelu, Pirunthavany and Novak, Leos and Pallewatte, Aruna S. and Shaaban, Mohamed and Shelly, Esti and Stepanyan, Karapet and Teo, Eu-Leong Harvey J. and Thelsy, Naw and Visrutaratna, Pannee and Zaman, Areesha and Zontar, Dejan",
year = "2012",
abstract = "OBJECTIVE. The purpose of this study was to assess the frequency of pediatric CT in 40 less-resourced countries and to determine the level of appropriateness in CT use. MATERIALS AND METHODS. Data on the increase in the number of CT examinations during 2007 and 2009 and appropriate use of CT examinations were collected, using standard forms, from 146 CT facilities at 126 hospitals. RESULTS. The lowest frequency of pediatric CT examinations in 2009 was in European facilities (4.3%), and frequencies in Asia (12.2%) and Africa (7.8%) were twice as high. Head CT is the most common CT examination in children, amounting to nearly 75% of all pediatric CT examinations. Although regulations in many countries assign radiologists with the main responsibility of deciding whether a radiologic examination should be performed, in fact, radiologists alone were responsible for only 6.3% of situations. Written referral guidelines for imaging were not available in almost one half of the CT facilities. Appropriateness criteria for CT examinations in children did not always follow guidelines set by agencies, in particular, for patients with accidental head trauma, infants with congenital torticollis, children with possible ventriculoperitoneal shunt malfunction, and young children ( LT 5 years old) with acute sinusitis. In about one third of situations, nonavailability of previous images and records on previously received patient doses have the potential to lead to unnecessary examinations and radiation doses. CONCLUSION. With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.",
journal = "American Journal of Roentgenology",
title = "IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness",
volume = "198",
number = "5",
pages = "1021-1031",
doi = "10.2214/AJR.11.7273"
}

Vassileva, J., Rehani, M. M., Al-Dhuhli, H., Al-Naemi, H. M., Al-Suwaidi, J. S., Appelgate, K., Aranđić, D., Bashier, E. H. O., Beganovic, A., Benavente, T., Bieganski, T., Dias, S., El-Nachef, L., Faj, D., Gamarra-Sanchez, M. E., Garcia-Aguilar, J., Gbelcova, L., Gershan, V., Gershkevitsh, E., Gruppetta, E., Hustuc, A., Ivanović, S., Jauhari, A., Kharita, M. H., Kharuzhyk, S., Khelassi-Toutaoui, N., Khosravi, H. R., Khoury, H., Kostova-Lefterova, D., Kralik, I., Liu, L., Mazuoliene, J., Mora, P., Muhogora, W., Muthuvelu, P., Novak, L., Pallewatte, A. S., Shaaban, M., Shelly, E., Stepanyan, K., Teo, E. H. J., Thelsy, N., Visrutaratna, P., Zaman, A.,& Zontar, D.. (2012). IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness. in American Journal of Roentgenology, 198(5), 1021-1031.
https://doi.org/10.2214/AJR.11.7273

Vassileva J, Rehani MM, Al-Dhuhli H, Al-Naemi HM, Al-Suwaidi JS, Appelgate K, Aranđić D, Bashier EHO, Beganovic A, Benavente T, Bieganski T, Dias S, El-Nachef L, Faj D, Gamarra-Sanchez ME, Garcia-Aguilar J, Gbelcova L, Gershan V, Gershkevitsh E, Gruppetta E, Hustuc A, Ivanović S, Jauhari A, Kharita MH, Kharuzhyk S, Khelassi-Toutaoui N, Khosravi HR, Khoury H, Kostova-Lefterova D, Kralik I, Liu L, Mazuoliene J, Mora P, Muhogora W, Muthuvelu P, Novak L, Pallewatte AS, Shaaban M, Shelly E, Stepanyan K, Teo EHJ, Thelsy N, Visrutaratna P, Zaman A, Zontar D. IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness. in American Journal of Roentgenology. 2012;198(5):1021-1031.
doi:10.2214/AJR.11.7273 .

Vassileva, Jenia, Rehani, Madan M., Al-Dhuhli, Humoud, Al-Naemi, Huda M., Al-Suwaidi, Jamila Salem, Appelgate, Kimberly, Aranđić, Danijela, Bashier, Einas Hamed Osman, Beganovic, Adnan, Benavente, Tony, Bieganski, Tadeusz, Dias, Simone, El-Nachef, Leila, Faj, Dario, Gamarra-Sanchez, Mirtha E., Garcia-Aguilar, Juan, Gbelcova, L'ubka, Gershan, Vesna, Gershkevitsh, Eduard, Gruppetta, Edward, Hustuc, Alexandru, Ivanović, Sonja, Jauhari, Arif, Kharita, Mohammad Hassan, Kharuzhyk, Siarhei, Khelassi-Toutaoui, Nadia, Khosravi, Hamid Reza, Khoury, Helen, Kostova-Lefterova, Desislava, Kralik, Ivana, Liu, Lantao, Mazuoliene, Jolanta, Mora, Patricia, Muhogora, Wilbroad, Muthuvelu, Pirunthavany, Novak, Leos, Pallewatte, Aruna S., Shaaban, Mohamed, Shelly, Esti, Stepanyan, Karapet, Teo, Eu-Leong Harvey J., Thelsy, Naw, Visrutaratna, Pannee, Zaman, Areesha, Zontar, Dejan, "IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness" in American Journal of Roentgenology, 198, no. 5 (2012):1021-1031,
https://doi.org/10.2214/AJR.11.7273 . .

TY  - JOUR
AU  - Ciraj-Bjelac, Olivera
AU  - Avramova-Cholakova, Simona
AU  - Beganovic, Adnan
AU  - Economides, Sotirios
AU  - Faj, Dario
AU  - Gershan, Vesna
AU  - Grupetta, Edward
AU  - Kharita, M. H.
AU  - Milakovic, Milomir
AU  - Milu, Constantin
AU  - Muhogora, Wilbroad E.
AU  - Muthuvelu, Pirunthavany
AU  - Oola, Samuel
AU  - Setayeshi, Saeid
AU  - Schandorf, Cyril
AU  - Ursulean, Ion
AU  - Videnovic, Ivan R.
AU  - Zaman, Areesha
AU  - Ziliukas, Julius
AU  - Rehani, Madan M.
PY  - 2012
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4996
AB  - Purpose: The objective is to study mammography practice from an optimisation point of view by assessing the impact of simple and immediately implementable corrective actions on image quality. Materials and methods: This prospective multinational study included 54 mammography units in 17 countries. More than 21,000 mammography images were evaluated using a three-level image quality scoring system. Following initial assessment, appropriate corrective actions were implemented and image quality was re-assessed in 24 units. Results: The fraction of images that were considered acceptable without any remark in the first phase (before the implementation of corrective actions) was 70% and 75% for cranio-caudal and medio-lateral oblique projections, respectively. The main causes for poor image quality before corrective actions were related to film processing, damaged or scratched image receptors, or film-screen combinations that are not spectrally matched, inappropriate radiographic techniques and lack of training. Average glandular dose to a standard breast was 1.5mGy (mean and range 0.59-3.2 mGy). After optimisation the frequency of poor quality images decreased, but the relative contributions of the various causes remained similar. Image quality improvements following appropriate corrective actions were up to 50 percentage points in some facilities. Conclusions: Poor image quality is a major source of unnecessary radiation dose to the breast. An increased awareness of good quality mammograms is of particular importance for countries that are moving towards introduction of population-based screening programmes. The study demonstrated how simple and low-cost measures can be a valuable tool in improving of image quality in mammography. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
T2  - European Journal of Radiology
T1  - Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects
VL  - 81
IS  - 9
SP  - 2161
EP  - 2168
DO  - 10.1016/j.ejrad.2011.05.026
ER  - 

@article{
author = "Ciraj-Bjelac, Olivera and Avramova-Cholakova, Simona and Beganovic, Adnan and Economides, Sotirios and Faj, Dario and Gershan, Vesna and Grupetta, Edward and Kharita, M. H. and Milakovic, Milomir and Milu, Constantin and Muhogora, Wilbroad E. and Muthuvelu, Pirunthavany and Oola, Samuel and Setayeshi, Saeid and Schandorf, Cyril and Ursulean, Ion and Videnovic, Ivan R. and Zaman, Areesha and Ziliukas, Julius and Rehani, Madan M.",
year = "2012",
abstract = "Purpose: The objective is to study mammography practice from an optimisation point of view by assessing the impact of simple and immediately implementable corrective actions on image quality. Materials and methods: This prospective multinational study included 54 mammography units in 17 countries. More than 21,000 mammography images were evaluated using a three-level image quality scoring system. Following initial assessment, appropriate corrective actions were implemented and image quality was re-assessed in 24 units. Results: The fraction of images that were considered acceptable without any remark in the first phase (before the implementation of corrective actions) was 70% and 75% for cranio-caudal and medio-lateral oblique projections, respectively. The main causes for poor image quality before corrective actions were related to film processing, damaged or scratched image receptors, or film-screen combinations that are not spectrally matched, inappropriate radiographic techniques and lack of training. Average glandular dose to a standard breast was 1.5mGy (mean and range 0.59-3.2 mGy). After optimisation the frequency of poor quality images decreased, but the relative contributions of the various causes remained similar. Image quality improvements following appropriate corrective actions were up to 50 percentage points in some facilities. Conclusions: Poor image quality is a major source of unnecessary radiation dose to the breast. An increased awareness of good quality mammograms is of particular importance for countries that are moving towards introduction of population-based screening programmes. The study demonstrated how simple and low-cost measures can be a valuable tool in improving of image quality in mammography. (C) 2011 Elsevier Ireland Ltd. All rights reserved.",
journal = "European Journal of Radiology",
title = "Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects",
volume = "81",
number = "9",
pages = "2161-2168",
doi = "10.1016/j.ejrad.2011.05.026"
}

Ciraj-Bjelac, O., Avramova-Cholakova, S., Beganovic, A., Economides, S., Faj, D., Gershan, V., Grupetta, E., Kharita, M. H., Milakovic, M., Milu, C., Muhogora, W. E., Muthuvelu, P., Oola, S., Setayeshi, S., Schandorf, C., Ursulean, I., Videnovic, I. R., Zaman, A., Ziliukas, J.,& Rehani, M. M.. (2012). Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects. in European Journal of Radiology, 81(9), 2161-2168.
https://doi.org/10.1016/j.ejrad.2011.05.026

Ciraj-Bjelac O, Avramova-Cholakova S, Beganovic A, Economides S, Faj D, Gershan V, Grupetta E, Kharita MH, Milakovic M, Milu C, Muhogora WE, Muthuvelu P, Oola S, Setayeshi S, Schandorf C, Ursulean I, Videnovic IR, Zaman A, Ziliukas J, Rehani MM. Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects. in European Journal of Radiology. 2012;81(9):2161-2168.
doi:10.1016/j.ejrad.2011.05.026 .

Ciraj-Bjelac, Olivera, Avramova-Cholakova, Simona, Beganovic, Adnan, Economides, Sotirios, Faj, Dario, Gershan, Vesna, Grupetta, Edward, Kharita, M. H., Milakovic, Milomir, Milu, Constantin, Muhogora, Wilbroad E., Muthuvelu, Pirunthavany, Oola, Samuel, Setayeshi, Saeid, Schandorf, Cyril, Ursulean, Ion, Videnovic, Ivan R., Zaman, Areesha, Ziliukas, Julius, Rehani, Madan M., "Image quality and dose in mammography in 17 countries in Africa, Asia and Eastern Europe: Results from IAEA projects" in European Journal of Radiology, 81, no. 9 (2012):2161-2168,
https://doi.org/10.1016/j.ejrad.2011.05.026 . .

TY  - JOUR
AU  - Ciraj-Bjelac, Olivera
AU  - Beganovic, Adnan
AU  - Faj, Dario
AU  - Gershan, Vesna
AU  - Ivanović, Sonja
AU  - Videnovic, Ivan R.
AU  - Rehani, Madan M.
PY  - 2011
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4462
AB  - The purpose of this work was to investigate status of imaging technology and practice in five countries in Eastern-European region and evaluate the impact of IAEA projects on radiation protection of patients. Information collected using standardized IAEA protocol included status of technology, practices and patient dose levels in interventional procedure, radiography, mammography and computed tomography (CT). In spite of increased number of digital units, single phase generators or units older than 30 year are still in use. Examples of obsolete practice such as using fluoroscopy for positioning, photofluorography, chest fluoroscopy and soft-beam technique for chest radiography are also in use. Modern multi-slice CT or digital mammography units are available; however, there is lack of adequate radiation protection and medical physics support in hospitals. Information on patient doses in interventional procedures, conventional radiography, mammography and CT was collected to have baseline data and corrective measures were proposed with appropriate follow up actions taken. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
T2  - European Journal of Radiology
T1  - Radiation protection of patients in diagnostic radiology: Status of practice in five Eastern-European countries, based on IAEA project
VL  - 79
IS  - 2
SP  - E70
EP  - E73
DO  - 10.1016/j.ejrad.2011.03.075
ER  - 

@article{
author = "Ciraj-Bjelac, Olivera and Beganovic, Adnan and Faj, Dario and Gershan, Vesna and Ivanović, Sonja and Videnovic, Ivan R. and Rehani, Madan M.",
year = "2011",
abstract = "The purpose of this work was to investigate status of imaging technology and practice in five countries in Eastern-European region and evaluate the impact of IAEA projects on radiation protection of patients. Information collected using standardized IAEA protocol included status of technology, practices and patient dose levels in interventional procedure, radiography, mammography and computed tomography (CT). In spite of increased number of digital units, single phase generators or units older than 30 year are still in use. Examples of obsolete practice such as using fluoroscopy for positioning, photofluorography, chest fluoroscopy and soft-beam technique for chest radiography are also in use. Modern multi-slice CT or digital mammography units are available; however, there is lack of adequate radiation protection and medical physics support in hospitals. Information on patient doses in interventional procedures, conventional radiography, mammography and CT was collected to have baseline data and corrective measures were proposed with appropriate follow up actions taken. (C) 2011 Elsevier Ireland Ltd. All rights reserved.",
journal = "European Journal of Radiology",
title = "Radiation protection of patients in diagnostic radiology: Status of practice in five Eastern-European countries, based on IAEA project",
volume = "79",
number = "2",
pages = "E70-E73",
doi = "10.1016/j.ejrad.2011.03.075"
}

Ciraj-Bjelac, O., Beganovic, A., Faj, D., Gershan, V., Ivanović, S., Videnovic, I. R.,& Rehani, M. M.. (2011). Radiation protection of patients in diagnostic radiology: Status of practice in five Eastern-European countries, based on IAEA project. in European Journal of Radiology, 79(2), E70-E73.
https://doi.org/10.1016/j.ejrad.2011.03.075

Ciraj-Bjelac O, Beganovic A, Faj D, Gershan V, Ivanović S, Videnovic IR, Rehani MM. Radiation protection of patients in diagnostic radiology: Status of practice in five Eastern-European countries, based on IAEA project. in European Journal of Radiology. 2011;79(2):E70-E73.
doi:10.1016/j.ejrad.2011.03.075 .

Ciraj-Bjelac, Olivera, Beganovic, Adnan, Faj, Dario, Gershan, Vesna, Ivanović, Sonja, Videnovic, Ivan R., Rehani, Madan M., "Radiation protection of patients in diagnostic radiology: Status of practice in five Eastern-European countries, based on IAEA project" in European Journal of Radiology, 79, no. 2 (2011):E70-E73,
https://doi.org/10.1016/j.ejrad.2011.03.075 . .

TY  - JOUR
AU  - Muhogora, Wilbroad E.
AU  - Ahmed, Nada A.
AU  - Almosabihi, Aziz
AU  - Alsuwaidi, Jamila S.
AU  - Beganovic, Adnan
AU  - Ciraj-Bjelac, Olivera
AU  - Kabuya, Francois K.
AU  - Krisanachinda, Anchali
AU  - Milakovic, Milomir
AU  - Mukwada, Godfrey
AU  - Ramanandraibe, Marie J.
AU  - Rehani, Madan M.
AU  - Rouzitalab, Jalil
AU  - Shandorf, Cyril
PY  - 2008
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/3448
AB  - OBJECTIVE. The purpose of this study was to survey image quality and the entrance surface air kerma for patients in radiographic examinations and to perform comparisons with diagnostic reference levels. SUBJECTS and METHODS. In this multinational prospective study, image quality and patient radiation doses were surveyed in 12 countries in Africa, Asia, and Eastern Europe, covering 45 hospitals. The rate of unsatisfactory images and image quality grade were noted, and causes for poor image quality were investigated. The entrance surface doses for adult patients were determined in terms of the entrance surface air kerma on the basis of X-ray tube output measurements and X-ray exposure parameters. Comparison of dose levels with diagnostic reference levels was performed. RESULTS. The fraction of images rated as poor was as high as 53%. The image quality improved up to 16 percentage points in Africa, 13 in Asia, and 22 in Eastern Europe after implementation of a quality control ( QC) program. Patient doses varied by a factor of up to 88, although the majority of doses were below diagnostic reference levels. The mean entrance surface air kerma values in mGy were 0.33 ( chest, posteroanterior), 4.07 ( lumbar spine, anteroposterior), 8.53 ( lumbar spine, lateral), 3.64 ( abdomen, anteroposterior), 3.68 ( pelvis, anteroposterior), and 2.41 ( skull, anteroposterior). Patient doses were found to be similar to doses in developed countries and patient dose reductions ranging from 1.4% to 85% were achieved. CONCLUSION. Poor image quality constitutes a major source of unnecessary radiation to patients in developing countries. Comparison with other surveys indicates that patient dose levels in these countries are not higher than those in developed countries.
T2  - American Journal of Roentgenology
T1  - Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects
VL  - 190
IS  - 6
SP  - 1453
EP  - 1461
DO  - 10.2214/AJR.07.3039
ER  - 

@article{
author = "Muhogora, Wilbroad E. and Ahmed, Nada A. and Almosabihi, Aziz and Alsuwaidi, Jamila S. and Beganovic, Adnan and Ciraj-Bjelac, Olivera and Kabuya, Francois K. and Krisanachinda, Anchali and Milakovic, Milomir and Mukwada, Godfrey and Ramanandraibe, Marie J. and Rehani, Madan M. and Rouzitalab, Jalil and Shandorf, Cyril",
year = "2008",
abstract = "OBJECTIVE. The purpose of this study was to survey image quality and the entrance surface air kerma for patients in radiographic examinations and to perform comparisons with diagnostic reference levels. SUBJECTS and METHODS. In this multinational prospective study, image quality and patient radiation doses were surveyed in 12 countries in Africa, Asia, and Eastern Europe, covering 45 hospitals. The rate of unsatisfactory images and image quality grade were noted, and causes for poor image quality were investigated. The entrance surface doses for adult patients were determined in terms of the entrance surface air kerma on the basis of X-ray tube output measurements and X-ray exposure parameters. Comparison of dose levels with diagnostic reference levels was performed. RESULTS. The fraction of images rated as poor was as high as 53%. The image quality improved up to 16 percentage points in Africa, 13 in Asia, and 22 in Eastern Europe after implementation of a quality control ( QC) program. Patient doses varied by a factor of up to 88, although the majority of doses were below diagnostic reference levels. The mean entrance surface air kerma values in mGy were 0.33 ( chest, posteroanterior), 4.07 ( lumbar spine, anteroposterior), 8.53 ( lumbar spine, lateral), 3.64 ( abdomen, anteroposterior), 3.68 ( pelvis, anteroposterior), and 2.41 ( skull, anteroposterior). Patient doses were found to be similar to doses in developed countries and patient dose reductions ranging from 1.4% to 85% were achieved. CONCLUSION. Poor image quality constitutes a major source of unnecessary radiation to patients in developing countries. Comparison with other surveys indicates that patient dose levels in these countries are not higher than those in developed countries.",
journal = "American Journal of Roentgenology",
title = "Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects",
volume = "190",
number = "6",
pages = "1453-1461",
doi = "10.2214/AJR.07.3039"
}

Muhogora, W. E., Ahmed, N. A., Almosabihi, A., Alsuwaidi, J. S., Beganovic, A., Ciraj-Bjelac, O., Kabuya, F. K., Krisanachinda, A., Milakovic, M., Mukwada, G., Ramanandraibe, M. J., Rehani, M. M., Rouzitalab, J.,& Shandorf, C.. (2008). Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects. in American Journal of Roentgenology, 190(6), 1453-1461.
https://doi.org/10.2214/AJR.07.3039

Muhogora WE, Ahmed NA, Almosabihi A, Alsuwaidi JS, Beganovic A, Ciraj-Bjelac O, Kabuya FK, Krisanachinda A, Milakovic M, Mukwada G, Ramanandraibe MJ, Rehani MM, Rouzitalab J, Shandorf C. Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects. in American Journal of Roentgenology. 2008;190(6):1453-1461.
doi:10.2214/AJR.07.3039 .

Muhogora, Wilbroad E., Ahmed, Nada A., Almosabihi, Aziz, Alsuwaidi, Jamila S., Beganovic, Adnan, Ciraj-Bjelac, Olivera, Kabuya, Francois K., Krisanachinda, Anchali, Milakovic, Milomir, Mukwada, Godfrey, Ramanandraibe, Marie J., Rehani, Madan M., Rouzitalab, Jalil, Shandorf, Cyril, "Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects" in American Journal of Roentgenology, 190, no. 6 (2008):1453-1461,
https://doi.org/10.2214/AJR.07.3039 . .