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Patient Radiation Exposure Information

Background

Section health physicist inspectors routinely collect patient radiation exposure information during our regulatory inspections of x-ray facilities. Exposure measurements are made using technique factors used by the facility for an average-size patient. The exposure is measured at the point where the x-rays enter the body.

Standard of Care

On the basis of the exposure measurements we collect, the Department's Ionizing Radiation Advisory Committee approves Standard of Care limits for several common radiographic projections. Although the Standard of Care limits are not regulations, they are considered by the Department to be upper limits which should not normally be exceeded for average-size patients. Standard of Care limits were initially set at approximately the 85th percentile of data for the preceeding five years. The limits undergo periodic review and may be revised by the Committee based on changes in exposure distribution or other factors. Standard of Care limits have not been established for dental intraoral radiographs (although non-regulatory upper acceptable limits are used), fluoroscopy, or cinefluorography.

Normal Ranges

Normal ranges of exposure are determined by the Section. These determinations are based on radiation measurements in medical facilities with properly functioning x-ray machines, appropriately selected x-ray film and intensifying screens, and good film processing. These facilities should have patient exposures at skin entrance, as measured in milliroentgens (mR), or radiation doses, as expressed in millirads (mrads), within normal ranges. Normal ranges have not been determined for fluoroscopy or cinefluorography.

Exposure Distribution Graphs

Graphs showing the distribution of radiation exposures over the preceeding five years can be viewed by clicking on the desired x-ray projection listed below. These graphs are updated annually. They are used to review the Standard of Care limits and to determine normal ranges.

National NEXT Program

The Nationwide Evaluation of X-Ray Trends (NEXT) is a national program conducted annually to measure the x-ray exposure that a standard patient receives for selected x-ray examinations.  Click on this link for information on some of the NEXT surveys in the form of PDF trifolds.

Patient radiation exposure information for common radiographic projections is presented in the table below. This information is available on form BHS/HFS-880; Patient Radiation Exposure Information (PDF format). Clicking on an x-ray projection from the list will display the exposure distribution graph.

Projection
(Click for Graph)
Standard of Care
Limit per Radiograph
Normal Range
PA Chest (without a grid) 20 mR 3-10 mR
PA Chest (with a grid) 25 mR 5-20 mR
AP Lumbar Spine 500 mR 100-400 mR
AP Cervical Spine 125 mR 25-100 mR
DP Foot 35 mR 5-15 mR
Hand 15 mR 3-10 mR
Dental Cephalometric 25 mR 5-15 mR
Mammography Mean Glandular Dose 200 mrads
 
Dental Intraoral

Fluoroscopy Rates

   
Cinefluorography Rates

Updated January 8, 2008

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Related Content
 •  Nationwide Evaluation of X-Ray Trends (NEXT)
 •  Michigan's Pursuit of an NRC Agreement
 •  Public Health Notifications
 •  Indoor Tanning
 •  Archives of the MDCH-RADIATION-SAFETY Listserv
 •  Dental Radiography: Doses and Film Speed

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