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Contrast investigations of hysterosalpingography (HSG) and retrograde urethrography (RUG) fluoroscopy procedures remain the dominant diagnostic tools for the investigation of infertility in females and urethral strictures in males, respectively, owing to the scarcity and high cost of services of alternative diagnostic technologies. In light of the radiological risks associated with contrast based investigations of the genitourinary tract systems, there is a need to assess the magnitude of radiation burden imparted to patients undergoing HSG and RUG fluoroscopy procedures in Tanzania. The air kerma area product (KAP), fluoroscopy time, number of images, organ dose and effective dose to patients undergoing HSG and RUG procedures were obtained from four hospitals. The KAP was measured using a flat transmission ionization chamber, while the organ and effective doses were estimated using the knowledge of the patient characteristics, patient related exposure parameters, geometry of examination, KAP and Monte Carlo calculations (PCXMC). The median values of KAP for the HSG and RUG were 2.2 Gy cm 2 and 3.3 Gy cm 2 , respectively. The median organ doses in the present study for the ovaries, urinary bladder and uterus for the HSG procedures, were 1.0 mGy, 4.0 mGy and 1.6 mGy, respectively, while for urinary bladder and testes of the RUG were 3.4 mGy and 5.9 mGy, respectively. The median values of effective doses for the HSG and RUG procedures were 0.65 mSv and 0.59 mSv, respectively. The median values of effective dose per hospital for the HSG and RUG procedures had a range of 1.6–2.8 mSv and 1.9–5.6 mSv, respectively, while the overall differences between individual effective doses across the four hospitals varied by factors of up to 22.0 and 46.7, respectively for the HSG and RUG procedures. The proposed diagnostic reference levels (DRLs) for the HSG and RUG were for KAP 2.8 Gy cm 2 and 3.9 Gy cm 2 , for fluoroscopy time 0.8 min and 0.9 min, and for number of images 5 and 4, respectively. The suggested DRLs for the HSG and RUG procedures may be used by the radiology departments in Tanzania for management of attained dose levels until the national DRLs are established. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the patient-specific equivalent organ dose (H T) and effective dose (ED) delivered to individual patients from cardiovascular interventional radiology (CVIR) procedures and to compare these doses to those reported in the literature. The H T and EDs to 113 patients from two CVIR procedures: coronary angiography (CA) and percutaneous coronary interventions (PCI) were acquired from two major hospitals in Tanzania. The H T and EDs were estimated using the knowledge of the patient characteristics, patient related exposure parameters, geometry of examination, measurements of air kerma area product and Monte Carlo-based PCXMC software. The median H T in the present study for the lung, heart and oesophagus for the CA, were 47.1 mSv, 33.8 mSv, and 22.9 mSv, respectively, while for the PCI were 102.6 mSv, 77.5 mSv, and 51.9 mSv, respectively. The median values of ED as recommended by ICRP 103 for the CA and PCI procedures were 11.1 mSv and 24.7 mSv, respectively. The overall variations between individual EDs across the two hospitals differed by factors of up to 63.1 and 25.1, respectively for the CA and PCI procedures. The mean values of H T and EDs in the present study were, for the most part, higher than the reported values for India, Belgium and Italy, while comparable with those reported for Greece. The proposed diagnostic reference levels (DRLs) for the CA and PCI were for KAP 91.4 Gy cm2 and 129.4 Gy cm2, for fluoroscopy time 15.5 min and 28.4 min, for number of cine frames 791.5 and 1213.5, and ED 19.8 and 36.9 mSv, respectively. The observed wide range of exposure parameters and patient doses within and across the hospitals and the observed relatively high patient doses compared to those reported in the literature, call for the need to standardize examination protocols and optimise radiation dose to patients from CVIR procedures. • Wide range of patient dose (H T and ED) within and across the hospitals were observed. • Mean values of KAP, H T and EDs were higher than the values reported from literature. • Proposed DRLs for CA and PCI were higher than reported DRLs from USA and Europe. [ABSTRACT FROM AUTHOR]