HDT joins FIT in the Cham Islands for Screening TB

From the 13th to the 17th of December 2019, Freundeskreis fur Internationale Tuberkulosehilfe (FIT) organized Tuberculosis (TB) screenings in the Cham Islands, Quang Nam province of Vietnam,

(a) to discover suspected tuberculosis patients and

(b) to evaluate the radiation dose effect of the X-ray generator on the operator.




FIT, through the Korean National Tuberculosis Association (KNTA), invited HDT to Danang and Cu Lao Cham (The Cham Islands). For these screenings, HDT took just the basic set for the MINE 2 Medical X-Ray System:


1. the MINE 2 medical X-ray generator (60 kV, 2 mA)


2. the 17-inch detector


3. and a laptop that includes the software.



The MINE 2 generates the X-rays and the

Detector reads and sends over the data to the laptop that holds our imaging software, where Dr. Tuegeh would be able to diagnose the data.


At the beginning of the screening, there were a few Acute Dose Rate (ADR) tests to evaluate the radiation dose of the generator. For this evaluation, the survey meter was placed as close to the generator as possible. To measure the radiation behind the direction of the cone, the survey meter was placed right near the rear edge of the MINE 2, as

shown in <Image 1> .




HDT’s ADR testing results, as shown in and , the radiation behind the MINE 2 generator continuously tested less than 0.1 μSv/h, which is 1000 times smaller than the radiation of the standard chest X-Ray equipment (as researched by WNA, Reuters, and Radiologyinfo.org, the radiation reading of standard chest X-rays is 0.10 mSv, or in other words, 100 μSv. Please refer to ). As for measuring the radiation right next to the cone of the generator, the tests continuously tested less than 0.2 μSv/h.


These results forced a conclusion that realistically, real-time measurements are meaningless. Thus, the team unanimously decided on collecting the data on the cumulative radiation dose measurement, after the screenings.




The MINE 2 generator and detector were set at 1 meter apart from each other, and the exposure time was set between 0.5 seconds to 0.8 seconds depending on the patient

description. The screenings were taken in two rural villages that did not have medical facilities necessary for non-portable X-ray equipment.



On December 15th 2019, 200 patients were diagnosed on the first day, and on the second day, December 16th 2019, 89 patients were diagnosed. Of the 289 patients, Dr. Tuegeh was able to diagnose 13 patients of being TB-positive, as shown in 5>.





A few days after the screening, on December 19th 2019, the ADR was once again measured. The Operator Exposure Dose resulted in 12.9μSv according to the survey meter, as shown in 6>.




As Radiologyinfo.org (supported by RSNA and ACR) clearly portraits in , at 0.1 mSv, the standard radiation dose is comparable to natural background radiation of 10 days.

However, after screening over 280 patients, HDT's MINE 2 generator, resulted at 12.9 μSv otherwise noted as 0.0129 mSv, which is over 7.7 times lower than the standard chest X-ray radiation dose.


This means that by using the standard X-ray system to take 1 X-ray, the patient is exposed to 10 days of natural background radiation. However, by using the MINE 2 X-Ray System, the operator (radiologist or certified doctor) is as safe as being exposed to natural background radiation for 30 hours, even after examining over 280 patients!





Results:


(A) Discover suspected tuberculosis patients:

-Was able to screen 289 patients in only 2 days

-Quick, Easy, and Efficient real-time diagnosing process

-Results: 13 patients out of 289 diagnosed as TB-positive

(B) Evaluate the radiation dose effect of the X-ray generator on the operator:

-After screening 289 patients in the short span of 2 days

-Exposure Time set between 0.5 seconds and 0.8 seconds, depending on patient description

-Follow-up Operator Exposure Dose test taken 3 days after the screenings

-Results: 12.9 μSv (which is the equivalent of around 30 hours of exposure to

natural background radiation.

Conclusion:

Not only was the screening and diagnosing process easily carried out, but the MINE 2 System is clearly efficient for rural environments that do not have facilities necessary for other typical X-ray systems, currently in the market. Not only is the MINE 2 System easy to set up, easy to use, and efficient for real-time diagnoses (especially in large masses), but with a reading of only 12.9μSv of the Operator Radiation Exposure Dose after diagnosing 289 patients in the span of 2 days, the MINE 2 has clearly proven to be safer for not only patients but also for operators.















This research was made possible due to the diligent efforts and collaboration of

FIT, SWEEP-TB, IRD, KNTA, STOP-TB, and HDT.