Typical Radiation Doses from Radiology Examinations

Lawrence T. Dauer, PhD, CHP

Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

General Radiological Examinations using X-Rays

(Dose/examination)

Examination Effective Dose Skin Dose Refs.

mSv mGy
estimate estimate
(range) (range)
Background Average per year ~3 (3-6) (1)
Round-trip flight, NY to London 0.1 (2)
Abdomen 1.2 (0.04-1.2) 2.7 (0.26-14.6) (3-12)
Barium enema 8 (2-18) (3-5,12)
Bone Densitometry (DEXA) 0.01 (0.0004-0.1) (1,4,5)
Chest 0.1 (0.02-0.81) 0.13 (0.01-1.5) (1,3-9,13-17)
Dental 0.05 (0.02-0.09) 1.6 (1.5-7) (4,5,7,9,16,18)
Extremities 0.001 (0.0002-0.1) 0.45 (3-6,12)
Galactography 0.7 (1)
Head, face, neck 0.1 (0.1-0.22) 2.5 (3,4,6)
Hip 0.7 (.18-2.71) 10 (5,7,12)
Hysterosalpingography 1 (1)
Intravenous Pyelogram (IVP) 1.6 (1.6-2.5) (1,5)
IV Urogram 2.95 10 (4,7)
Lower GI tract 4.0 (1)
Knee 0.005 (12)
Mammography (4 views) 0.7 7 (1-4,7,14)
[1-3 mSv breast]
Myelography 4 (1)
Pediatric Chest 0.05 (0.02-0.1) (9,19)
Pelvis 0.6 (0.2-1.2) 4 (0.24-15.4) (1,3-8,12-15)
Shoulder 0.01 (12)
Skull 0.01 (0.01-0.22) 4 (0.7—9.9) (5,7,12,14,15)
Spine 1.0 (0.4-1.04) 3.21 (0.5-68.4) (3-
10,12,14,15,20)
Upper GI tract 6.0 (1.5-12) (3,4,9,12)
Voiding Cystourethrogram 5-10yrs 1.6 (1)
Voiding Cystourethrogram infant 0.8 (1)

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 1 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

Computed Tomography Radiological Examinations using X-Rays

(Dose/examination)

Examination Effective Dose CTDIvol References

mSv mGy
estimate
(range)
Background Average per year 03 (3-6) (1)
CT – Abdomen 8 (3.5-27.4) 15-25 (3-5,7,9,10,12,16,21,22)
CT – Angioplasty (heart study) 25 (7.5-57) (5,22)
CT - Attenuation Scan for PET adult 0.72 0.64-10.19 (23,24)
CT – Attenuation Scan for PET child 0.92-20.20 (24)
CT – Calcium Scoring 3 (1.0-12) (12)
CT - Cancer Scoring 2 (3)
CT – Cardiac ECG Pulsing, no aorta 9 (13)
CT – Cardiac for Calcium Scoring 2 (1)
CT – Cardiac No ECG Pulsing, aorta 29 (13)
CT – Chest 7 (4.0-20.5) (3-5,9,12,22)
CT – Chest for Pulmonary Embolism 15 (13-40) (12)
CT – Coronary Angiography 16 (4.6-15.8) (3,12,22)
CT – Extremity 0.15 (3)
CT – Gated Cardiac 20.0 (3)
CT – Head 2 (0.8-5) 60 (3-5,7,9,10,16,21,22)
CT – Kidneys 10 (7.6-10) (22)
CT – Liver 10 (6.5-12.7) (22)
CT – Neck 3 (12)
CT – Pediatric Abdomen 20 (21)
CT – Pelvis 6 (3.3-10) 15-25 (3-5,7,9,10,12,16,21,22)
CT – Sinuses 0.6 (1)
CT - Spine 6 (1.5-12) 35 (3,7,12,22)
CT - Virtual Colonoscopy 10.0 (4-13.2) (1,3,12)
CT - Whole Body Screen 10 (3)
Note – for pediatric cases, multiply these values by ~2.

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 2 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

Interventional Radiology Procedures using Fluoroscopic X-Rays

(Dose/examination)

Examination Skin Dose Effective Dose References

mGy mSv
estimate estimate
(range) (range)
Normal Mode – Skin Dose 25 mGy/min (7)
High Level Mode – Skin Dose 100 mGy/min (7)
TIPS 70 (20-180) (12)
Mobile C-Arm Units 22 mGy/min (9)
Embolization – Pelvic Entry 60 (44-78) (12)
Upper GI Exam 45 mGy/min (9,25)
Cardiac rhythm device 3 (1.4-5.5) (13)
Coronary angiography 7 (2.0-15.8) (12)
Coronary angioplasty 38 mGy/min 18 (6.8-28.9) (9,13)
Coronary radiofrequency ablation 20 (17-25) (13)

Estimated Peak Skin Dose (mGy)

st
MSKCC Study 1 3rd
Procedure Description Quartile Median Quartile Maximum
Abscess drainage 42 115 272 1736
Abscess catheter change 70 137 233 1736
Fistulagram 378 612 833 1055
Biliary drainage 401 660 1020 3569
Biliary stent 245 499 799 1811
Biliary catheter exchange 86 174 345 1876
Mediport chest 8 12 22 619
Non-tunneled venous catheter 7 11 24 700
Tunneled venous catheter 9 18 36 254
Hepatic embolization 1251 1959 2968 9528
Portal embolization 1307 1850 2696 5105
Arterial embolization, other 1761 3038 3918 8073
Foreign body retrieval 337 683 822 1139
IVC filter 162 261 422 2686
Genitourinary catheter exchange 74 143 260 1568
Needle biopsy 11 25 52 485

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 3 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

Radiological Examinations using Nuclear Medicine (26)

Nuclear Medicine Activity Activity Effective
(mCi) (MBq) Dose
(mSv)
Background Average per year 3 (3-6)
H-3 Glucose 0.08 2.96 0.045
C-14 Urea 0.001 0.037 0.001
F-18 FDG (not including associated CT) 15 555 8.88
Ga-67 Citrate 5 185 18.5
I-123 Hippuran 0.4 14.8 0.177
I-123 MIBG 10 370 4.81
I-123 Sodium Iodide (0% uptake) 0.4 14.8 0.192
I-123 Sodium Iodide (55% uptake) 0.4 14.8 3.404
I-125 Albumin 0.02 0.74 0.251
I-131 Hippuran 0.02 0.74 0.038
I-131 MIBG 1 37 7.4
I-131 Sodium Iodide (0% uptake) 100 3700 266.4
In-111 Octreoscan 6 222 11.988
In-111 White Blood Cells 0.5 18.5 11.802
O-15 Water 10 370 0.344
P-32 Phosphate 4 148 325.6
Rb-82 50 1850 6.29
Sm-153 Quadramet 1 37 7.3
Sr-89 Chloride (Metastron) 4 148 429.2
Tc-99m Apcitide (AcuTec) 20 740 6.882
Tc-99m Depreotide (NeoTect) 20 740 17.02
Tc-99m Disofenin (HIDA) 5 185 3.145
Tc-99m DMSA (Succimer) 5 185 1.628
Tc-99m Exametazime (HMPAO) 20 740 6.882
Tc-99m Macro aggregated albumin (MAA) 4 148 1.628
Tc-99m Methylenediphosphonate (MDP) 20 740 4.218
Tc-99m Mertiatide (MAG3), normal renal 20 740 5.18
Tc-99m Mertiatide (MAG3), abnormal renal 20 740 4.513
Tc-99m Mertiatide (MAG3), renal blockage 20 740 7.407
Tc-99m Pentatate (DTPA) 10 370 1.813
Tc-99m Pyrophosphate 15 555 3.163
Tc-99m Red Blood Cells 20 740 5.18
Tc-99m Sestamibi (Cardiolite, rest) 20 740 6.66 (6-12)
Tc-99m Sestamibi (Cardiolite, stress) 20 740 5.846 (5-17.5)
Tc-99m Sodium Pertechnetate 10 370 4.81
Tc-99m Sulfur Colloid 8 296 2.782
Tc-99m Technegas 20 740 11.1
Tc-99m Tetrofosmin (Myoview, rest) 20 740 5.624
Tc-99m Tetrofosmin (Myoview, stress) 20 740 5.624
Tl-201 Thallous Chloride (with contaminants) 2 74 11.84

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 4 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

Fetal Doses from Radiological Examinations using X-Rays

Extra-Abdominal X-Ray Examinations (Dose/examination)

Examination Fetal Dose Reported Range References

(mGy) (mGy)
Background Average 0.7 0.5-1 (27)
CT – Head 0 (6)
Skull (radiographic) 0 (28)
Foot 0.0001 (28)
Cervical spine 0.001 (27)
Dental 0.001 ~0-0.001 (28,29)
Chest (radiographic, PA, LAT) 0.002 0.0001-0.43 (27-30)
Thoracic spine (AP, LAT) 0.003 <0.001-0.55 (27,29,30)
Extremities 0.005 <0.001-0.18 (27,29)
Pulmonary Embolism (1st Tri.) 0.006 0.006-0.05 (31)
Femur (distal) 0.01 0.01-0.50 (29)
Head-cervical spine 0.01 <0.005-0.03 (29)
Shoulder 0.01 <0.005-0.03 (29)
CT – Chest 0.02 0.02-0.16 (6,27)
Pulmonary Embolism (2nd Tri.) 0.02 0.022-0.26 (27,31)
Pulmonary Embolism (3rd Tri.) 0.07 0.278-0.86 (27)
Cardiac Cath Ablation (1st Tri.) 0.1 0.10-0.20 (32)
CT - Angiography of coronary 0.1 (27)
arteries
Mammography 0.1 (22)
Chest (photofluorographic) 0.2 0.009-0.40 (29)
Cardiac Cath Ablation (2nd Tri.) 0.300 (32)
Cardiac Cath Ablation (3rd Tri.) 0.557 (32)
CT – Lung 1.2 1.0-1.4 (30)
CT – Abdomen 30 (6)

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 5 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

Fetal Doses from Radiological Examinations using X-Rays

Abdominal Examinations (Dose/examination)

Examination Fetal Dose Reported References

(mGy) Range
(mGy)
Digital pelvimetry 0.5 0.05-0.35 (29)
Abdomen (21 cm thick patient) 1 (27)
Cholecystography/ 1 0.05-16.0 (6,29,30)
Cholangiography
Upper GI 1 0.05-12.0 (6,29)
Barium meal 1.5 0.1-5.8 (30)
CT - Pelvimetry (single slice) 2.5 1.6-5 (29,33)
CT - Lumbar spine 2.8 (30)
Abdomen (33 cm thick patient) 3 (27)
Hips and femur 3 0.73-14.0 (6,29)
CT - Liver 3.6 2.0-4.4 (30)
Urinary Bladder (AP) 3.9 0.56-11.0 (30)
Abdomen (KUB) 4 0.21-19.0 (6,27-30,34)
Lumbar/Lumbosacral spine 4 0.20-40.0 (6,27-30)
(AP, LAT)
TIPS Procedure (2nd Trimester) 5.5 (35)
Urography, IV or Retrograde 6 0.70-55.0 (6,29,30)
pyelogram
Small bowel study (6 min 7 (27)
fluoro + 20 images)
Barium enema 10 0.28-130 (6,29,30,34)
CT - Abdomen/Pelvis (stone 10 (27)
protocol)
Film pelvimetry 10 0.35-55.0 (29)
Hysterosalpinography 10 2.7-92 (6,29)
Pelvis 10 0.55-22.0 (6,29,30)
Urethrocystography 10 2.70-41.0 (29)
CT - Abdomen (3rd Trimester) 30 29.1-42.0 (36)
CT - Abdomen/Pelvis (routine) 30 10-60 (6,27,29,34,37)
CT - Angiography of aorta 34 (27)
(chest through pelvis)
CT - Abdomen (2nd Trimester) 35 30-43.6 (36)
CT - Pelvis 89 65.0-114.0 (30)

Department of Medical Physics 2008

Memorial Sloan-Kettering Cancer Center 6 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

References:

1. RSNA. Radiation exposure in x-ray examinations. RadiologyInfo: the radiology information resource for patients.:
Radiological Society of North America, Inc., 2007.
2. Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we
really know. Proc Natl Acad Sci U S A 2003;100:13761-6.
3. Mettler F, Thomadsen B, Bhargavan M, et al. Medical radiation exposure in the U.S. 2006: preliminary results. Health Phys
2008;Pending.
4. Wall BF, Hart D. Revised radiation doses for typical X-ray examinations. Report on a recent review of doses to patients from
medical X-ray examinations in the UK by NRPB. National Radiological Protection Board. Br J Radiol 1997;70:437-9.
5. HPS. Radiation exposure from medical diagnostic imaging procedures. Health Physics Society Fact Sheet.: Health Physics
Society www.hps.org, 2008.
6. Parry RA, Glaze SA, Archer BR. The AAPM/RSNA physics tutorial for residents. Typical patient radiation doses in
diagnostic radiology. Radiographics 1999;19:1289-302.
7. IAEA. Safety report series no. 39. Applying radiation safety standards in diagnostic radiology and interventional procedures
using x rays. Jointly sponsored by IAEA, ILO, ISRRT, ISR, IOMP, PAHO, WHO. Vienna, Austria: International Atomic
Energy Agency, 2006.
8. Hart D, Hillier M, Wall B. NRPB-W14 - doses to patients from medical x-ray examinations in the UK - 2000 review. .
Chilton, UK: National Radiological Protection Board, 2002.
9. FDA. Nationwide evaluation of x-ray trends (NEXT) - data summaries. www.fda.gov. Food and Drug Administration, 2003.
10. FDA. Nationwide evaluation of x-ray trends 2000 computed tomography.: Conference of Radiation Control Program
Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health., 2006.
11. FDA. Nationwide evaluationof x-ray trends (NEXT) 2002 abdomen radiography survey.: Conference of Radiation Control
Program Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health, 2006.
12. Mettler FA, Jr., Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog.
Radiology 2008;248:254-63.
13. Picano E, Vano E, Semelka R, Regulla D. The American College of Radiology white paper on radiation dose in
medicine:deep impact on the practice of cardiovascular imaging. Cardiovasc Ultrasound 2007;5:37.
14. IAEA. IAEA-TECDOC-796. Radiation doses in diagnostic radiology and methods for dose reduction. Report of a co-
ordinated research programme jointly organized by the International Atomic Energy Agency and the Commission of the
European Communities (1991-1993) Vienna, Austria: International Atomic Energy Agency, 1995.
15. IAEA. IAEA-TECDOC-1423. Optimization of the radiological protection of patients undergoing radiography, fluoroscopy
and computed tomography. Final report of a coordinated research project in Africa, Asia, and eastern Europe. . Vienna,
Austria: International Atomic Energy Agency, 2004.
16. Gray JE, Archer BR, Butler PF, et al. Reference values for diagnostic radiology: application and impact. Radiology
2005;235:354-8.
17. FDA. Nationwide evaluation of x-ray trends 2001 adult chest radiography. . Conference of Radiation Control Program
Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health., 2005.
18. FDA. Nationwide evaluation of x-ray trends (NEXT) 1999 dental x-ray data.: Conference of Radiation Control Program
Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health, 2003.
19. FDA. Nationwide evaluation of x-ray trends (NEXT) 1998 pediatric chest x-ray data. . Conference of Radiation Control
Program Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health, 2003.
20. FDA. Nationwide evaluation of x-ray trends (NEXT) 2002 lumbosacral (LS) spine radiography survey.: Conference of
Radiation Control Program Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health,
2006.
21. ACR. CT accreditation program requirements. www. acr.org. American College of Radiology, 2008.
22. UNSCEAR. Sources and effects of ionizing radiation, Vol. 1: Sources. United Nations Scientific Committee on the Effects of
the Atomic Radiation. New York: United Nations Publishing, 2000.
23. Wu TH, Chu TC, Huang YH, et al. A positron emission tomography/computed tomography (PET/CT) acquisition protocol
for CT radiation dose optimization. Nucl Med Commun 2005;26:323-30.
24. Fahey FH, Palmer MR, Strauss KJ, Zimmerman RE, Badawi RD, Treves ST. Dosimetry and adequacy of CT-based
attenuation correction for pediatric PET: phantom study. Radiology 2007;243:96-104.
Department of Medical Physics 2008
Memorial Sloan-Kettering Cancer Center 7 of 8
 Typical Radiation Doses from Radiology Examinations
Lawrence T. Dauer, PhD, CHP
Assistant Attending Health Physicist, Radiation Safety Manager
1 mSv = 100 mrem; 10 mSv = 1 rem
1mGy = 100 mrad; 10 mGy = 1 rad

25. FDA. Nationwide evaluation of x-ray trends (NEXT) - upper G.I. fluoroscopic survey.: Conference of Radiation Control
Program Directors, Inc. and Food and Drug Administration Center for Devices and Radiological Health, 1996.
26. Stabin M. RADAR medical procedure radiation dose calculator and consent language generator.: Radiation Dosimetry
Assessment Resource www.doseinfo-radar.com, 2008.
27. McCollough CH, Schueler BA, Atwell TD, et al. Radiation exposure and pregnancy: when should we be concerned?
Radiographics 2007;27:909-17; discussion 917-8.
28. Vetter RJ. Radiation exposure of fertile women in medical research studies. Health Phys 1988;55:487-91.
29. Wagner LK, Lester RG, Saldana LR. Exposure of the pregnant patient to diagnostic radiations: a guide to medical
management, 2nd edition. Madison, WI: Medical Physics Publishing, 1997.
30. Osei EK, Faulkner K. Fetal doses from radiological examinations. Br J Radiol 1999;72:773-80.
31. Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary embolism in pregnant
patients: fetal radiation dose with helical CT. Radiology 2002;224:487-92.
32. Damilakis J, Theocharopoulos N, Perisinakis K, et al. Conceptus radiation dose and risk from cardiac catheter ablation
procedures. Circulation 2001;104:893-7.
33. Moore MM, Shearer DR. Fetal dose estimates for CT pelvimetry. Radiology 1989;171:265-7.
34. Helmrot E, Pettersson H, Sandborg M, Alten JN. Estimation of dose to the unborn child at diagnostic X-ray examinations
based on data registered in RIS/PACS. Eur Radiol 2007;17:205-9.
35. Savage C, Patel J, Lepe MR, Lazarre CH, Rees CR. Transjugular intrahepatic portosystemic shunt creation for recurrent
gastrointestinal bleeding during pregnancy. J Vasc Interv Radiol 2007;18:902-4.
36. Damilakis J, Perisinakis K, Voloudaki A, Gourtsoyiannis N. Estimation of fetal radiation dose from computed tomography
scanning in late pregnancy: depth-dose data from routine examinations. Invest Radiol 2000;35:527-33.
37. Hurwitz LM, Yoshizumi T, Reiman RE, et al. Radiation dose to the fetus from body MDCT during early gestation. AJR Am
J Roentgenol 2006;186:871-6.

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