An approach for the online determination of Entrance Surface Air Kerma (ESAK) from Kerma Area product (PKA) in digital radiology

Ibrahim I. Suliman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


We propose determining the entrance surface air kerma (ESAK) from the kerma area product (P KA) in digital radiology. ESAK values were derived from the X-ray tube outputs and patient exposure factors across five X-ray departments. Using linear regression between ESAK and P KA values, the slope and intercept coefficients were determined for each X-ray equipment and procedure. The method was examined using the data collected from patients who underwent chest PA/LAT, abdomen, pelvic AP, and lumbar spine AP/LAT X-ray examinations. The results showed a highly significant correlation between ESAK and P KA values and correlation coefficients, ranging from 0.77 to 1 with P-value < 0.001 in most studies. This method can be employed by incorporating dose data and related parameters into the X-ray device's software, similar to other dose-displayed information. The online determination of ESAK from P KA could help with quality assurance and patient dose management in digital radiology.

Original languageEnglish
Pages (from-to)1055-1061
Number of pages7
JournalPhysical and Engineering Sciences in Medicine
Issue number4
Publication statusPublished - Dec 2022
Externally publishedYes


  • Digital Imaging and Communications in Medicine (DICOM)
  • Digital radiology
  • Dose display
  • Patient dose
  • Radiation measurements
  • Radiography
  • Humans
  • Radiographic Image Enhancement/methods
  • Radiology
  • Radiation Dosage
  • Fluoroscopy/methods

ASJC Scopus subject areas

  • Biotechnology
  • Radiological and Ultrasound Technology
  • Biophysics
  • Biomedical Engineering
  • Instrumentation
  • Radiology Nuclear Medicine and imaging

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