PENENTUAN DIAGNOSTIC REFERENCE LEVEL (DRL) PADA PEMERIKSAAN RADIOGRAFI THORAKS PEDIATRIK MENGGUNAKAN METODE ENTRANCE SURFACE DOSE (ESD) DI RSUD DR. SOESELO KABUPATEN TEGAL
DOI:
https://doi.org/10.51878/healthy.v5i4.15689Keywords:
Diagnostic Reference Level, Entrance Surface Dose, Radiografi Thoraks Pediatric, High kV, Proteksi RadiasiAbstract
Chest radiography is one of the most frequently performed radiographic examinations in pediatric patients at the Radiology Installation of RSUD dr. Soeselo Tegal Regency. However, the facility currently does not have a local Diagnostic Reference Level (DRL) that can be used as an internal reference for patient radiation dose evaluation. This study aimed to determine the local DRL for pediatric chest radiography using the Entrance Surface Dose (ESD) method and to evaluate its conformity with national references and international literature. This study employed a descriptive quantitative design conducted from December 2025 to April 2026 at the Radiology Installation of RSUD dr. Soeselo Tegal Regency. The study sample consisted of 20 pediatric patients aged 5–14 years selected using a purposive sampling technique. Data were obtained from exposure parameters of posteroanterior chest radiography examinations performed using a Digital Radiography system. Dose estimation was performed by calculating Incident Air Kerma (INAK) based on tube output, which was subsequently converted into ESD using a Backscatter Factor (BSF). The local DRL value was determined based on the 75th percentile of the ESD distribution. The results showed that the ESD values ranged from 0.07251 to 0.16406 mGy, with a 75th percentile value of 0.12992 mGy as the local DRL for pediatric chest radiography at RSUD dr. Soeselo Tegal Regency. This value represents the dose characteristics of pediatric chest radiography using Digital Radiography and can be used as an internal reference for dose monitoring and examination protocol evaluation. Comparison with national references should be interpreted carefully because BAPETEN uses the Entrance Surface Air Kerma (ESAK) parameter, whereas this study uses ESD.
ABSTRAK
Pemeriksaan radiografi thoraks merupakan salah satu pemeriksaan radiografi yang rutin dilakukan pada pasien pediatrik di Instalasi Radiologi RSUD dr. Soeselo Kabupaten Tegal. Namun, hingga saat ini belum tersedia Diagnostic Reference Level (DRL) lokal yang dapat digunakan sebagai acuan internal dalam evaluasi dosis radiasi pasien. Penelitian ini bertujuan untuk menentukan DRL lokal pada pemeriksaan radiografi thoraks pediatrik menggunakan metode Entrance Surface Dose (ESD) serta mengevaluasi kesesuaiannya dengan acuan nasional dan literatur internasional. Penelitian ini merupakan penelitian kuantitatif deskriptif yang dilakukan pada Desember 2025–April 2026 di Instalasi Radiologi RSUD dr. Soeselo Kabupaten Tegal. Sampel penelitian terdiri atas 20 pasien pediatrik usia 5–14 tahun yang dipilih menggunakan teknik purposive sampling. Data diperoleh dari parameter eksposi pemeriksaan radiografi thoraks proyeksi posteroanterior menggunakan sistem Digital Radiography. Estimasi dosis dilakukan melalui perhitungan Incident Air Kerma (INAK) berbasis tube output yang kemudian dikonversi menjadi ESD menggunakan faktor hambur balik (Backscatter Factor/BSF). Nilai DRL lokal ditentukan berdasarkan persentil ke-75 distribusi ESD. Hasil penelitian menunjukkan bahwa nilai ESD berada pada rentang 0,07251–0,16406 mGy dengan nilai persentil ke-75 sebesar 0,12992 mGy sebagai DRL lokal pemeriksaan radiografi thoraks pediatrik di RSUD dr. Soeselo Kabupaten Tegal. Nilai tersebut memberikan gambaran karakteristik dosis pada praktik radiografi thoraks pediatrik berbasis Digital Radiography dan dapat digunakan sebagai acuan internal untuk pemantauan dosis serta evaluasi protokol pemeriksaan. Perbandingan dengan acuan nasional perlu dilakukan secara hati-hati karena BAPETEN menggunakan parameter Entrance Surface Air Kerma (ESAK), sedangkan penelitian ini menggunakan ESD.
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