Evaluation of radiation dose to organs of neonatal patients during portable X-ray examination in incubators: A Monte Carlo simulation study

BACKGROUND: Infants admitted to neonate intensive care units (NICUs) are placed in incubators to maintain body temperature and condition, which undergo normal radiographs and are exposed to radiation. Furthermore, different incubator structures in different hospitals exhibit varying object to image receptor distance (OID), source to image receptor distance (SID), presence of canopy, which results in variations in X-ray radiation conditions and doses absorbed by the neonatal patients. OBJECTIVE: To measure organ dose exposed to neonatal patient in different incubator settings. METHODS: A portable X-ray was performed on a neonatal patient placed in an incubator to identify disease progress, the injection path of the drug, and various factors. To minimize direct contact between neonatal patients and image receptor, radiologic technologists place the image receptor on a tray underneath the incubator and place the portable X-ray tube on top of the acrylic canopy of the incubators. SID and OID settings and value of organ dose exposed to the patient varied based on the incubator structure, and the organ absorbed dose was determined using Monte Carlo N-Particle (MCNP) simulation, PC-based Monte Carlo program (PCXMC) 2.0 simulation, and neonate phantoms. RESULTS: Evaluations of organ dose of neonatal patients in three hospitals with different incubator settings reveal that the average organ dose differs by 36% depending on change in OID and SID settings and reduces by 10% with an acrylic canopy. Therefore, owing to the presence of an acrylic canopy on the top of the incubator and the longer SID with the corresponding shorter OID, a lower dose was absorbed by organs of neonatal patient. CONCLUSION: Our results provide proof that proper incubator standard decreases organ dose to neonatal patient during continuously diagnostic X-ray procedure.