This survey was carried out in the state of São Paulo, Brazil. The health services located in the state perform approximately 321 radiological examinations per 1000 inhabitants. A representative sample of 200 health services was selected using sampling techniques, and a postal dosimetric kit was sent to each one who agreed to participate. The kit evaluates entrance surface dose (ESD), making use of thermoluminescence dosemeters attached to the skin of patients. The radiographic technique employed and some physical data of patients were also gathered. In this stage of the survey, only chest examinations, projections AP, PA and LAT, were evaluated. A total of 917 ESD values were measured, which correspond to 588 patients and 74 examination rooms. The ESD to patients were analysed according to weight and age. Groups of standard patients (children and adults) were selected, and reference doses were determined. Large variations of ESD were observed, indicating that much can be done in order to reduce the patient doses by changing the technical parameters. Moreover, the results of ESD in paediatric radiology point to the necessity of special attention in the practice of radiological examinations in this age group.

Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma–area product—P_KA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of P_KA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups.

A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in São Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state.

OBJETIVO: Realizar um levantamento no Estado de São Paulo das informações referentes a equipamentos de diagnóstico por imagem e exames radiológicos. MATERIAIS E MÉTODOS: Essas informações foram obtidas através do Departamento de Informática do Sistema Único de Saúde (Datasus). A distribuição de equipamentos e a freqüência anual de exames foram analisadas considerando-se as diferentes regiões de saúde (Diretorias de Saúde) que compõem o Estado e suas respectivas populações. RESULTADOS: Os resultados obtidos apontam para diferenças regionais significativas, tanto em relação à distribuição de equipamentos como à freqüência de exames. Comparações com dados disponíveis de outros países indicam que pode haver demanda por parte da população em relação a exames de diagnóstico por imagem, principalmente no caso de mamografia, embora o acesso público a esses serviços tenha melhorado nos últimos anos. CONCLUSÃO: Estudos como este demonstram a importância da democratização das informações do sistema de saúde do País e contribuem para uma análise sistemática e objetiva de áreas específicas, servindo de referência para futuros trabalhos.