Patient Dose Assessment and Diagnostic Reference Levels in Routine Adult PA Chest Radiography: A Narrative Review
DOI:
https://doi.org/10.64354/p84hq190Keywords:
diagnostic reference levels; chest radiography; patient dose; posteroanterior radiography; digital radiography; radiation protectionAbstract
Background: Diagnostic reference levels (DRLs) support dose optimisation, but differences in patient selection, technology and dosimetry complicate comparisons in adult posteroanterior (PA) chest radiography. Purpose: To provide a focused, method-aware synthesis of published reference values and their practical interpretation. Methods: The existing narrative evidence base was supplemented on 6 October 2026 by targeted web searches for PubMed/PMC records, publisher pages and official radiation-protection guidance. Recent evidence published from January 2020 to the search date was prioritised, with earlier foundational guidance retained. Projection, patient size, detector technology, dose quantity, measurement approach and statistical basis were extracted where accessible. Results: Selected studies reported surface-dose/kerma reference values of 0.20–0.68 mGy, which are not automatically equivalent quantities. PA chest kerma-area-product values included 51 mGy·cm² in Dubai, 77 mGy·cm² in the UK and 769.23 mGy·cm² in the Korean equipment survey. These differences cannot be interpreted as a ranking because the studies differ in sampling, dosimetry and reference-level derivation. Conclusion: The practical contribution is a comparability checklist and an investigation pathway linking dose variation to patient size, equipment, exposure technique, measurement uncertainty and diagnostic image quality. DRLs should guide group-level investigation and iterative optimisation, rather than serve as individual patient limits or universal dose targets.
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