Gonad shielding in pelvic radiography: modern optimised X-ray systems might allow its discontinuation

Insights into Imaging

Table 4 Cumulative effective dose caused by AP pelvic radiography in 35 European countries

Scenario	Source effective dose per radiograph	Source of annual frequency of pelvic radiographs (RP180)	Cumulative effective dose^a, kmanSv	Percentage
1	Individual countries (RP180)^b	Individual countries	26.4	≡100
2	“European” DRL (RP180)^c	,,	16.1	61
3	Dutch target DRL^c	,,	8.0	30
4	MUMC+	,,	3.0	11
5	Individual countries (RP180)	The Netherlands (RP180)^d	18.7	71

^a Cumulative effective dose is the sum of the effective dose over all exposed persons in the 35 countries (k in kman-Sv stands for kilo, i.e. 1000)
^b Assuming AP projection dominates pelvic effective dose given in RP180
^c Most common DRL in Europe is a KAP of 3.0 Gy cm², also in the Netherlands [70]. The Dutch target is 1.5 Gy cm², however [74]
^d The annual frequency of pelvic radiographs in the Netherlands is 39.8 per 1000 population [77]