An Approach for Online Determining the Entrance Surface Air Kerma (ESAK) in Digital Radiology

Abstract An online method is proposed to determine the entrance surface air kerma (ESAK) in digital radiology from console-displayed kerma area product (PKA) data. ESAK values were calculated from X-ray tube outputs and patient exposure factors across five X-ray examinations. The corresponding PKAvalues were taken from the Digital Imaging and Communications in Medicine (DICOM) header. Using linear regression between ESAK and values, the slope and intercept coefficients for each type of X-ray equipment and procedure were determined. The coefficient to determine ESAK from ranged from 59% for a posteroanterior chest to 88% for anteroposterior lumbar spine view X-ray procedures. The results demonstrated the possibility of online estimates of ESAK from a console that displayed using readily available digital information in radiology. The results may have important implications in interventional radiology, where ESAK values are crucial for preventing skin injuries due to prolonged fluoroscopy times.