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SErIES IAEA HumAn HEAltH SErIES IAEA Hum

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DETERMINATION OF INCIDENT AIR KERMA<br />

USING THE CDRH CHEST PHANTOM<br />

User: _________________________________<br />

K i Phantom:<br />

Chest 1<br />

Date: ______________<br />

Hospital or clinic name: ________________________________________________________<br />

1. X ray equipment<br />

X ray facility and model: ________________<br />

Imaging using screen–film combination<br />

Room No.: _________<br />

Imaging using digital image receptor<br />

Screen–film combination: _______________ Image receptor model: ___________________<br />

Film processor model: _________________________<br />

Developer and fixer (brand name): _______________.<br />

2. Dosimeter and phantom<br />

Dosimeter model: _________ Serial No.: _________ Date of calibration: _________<br />

Calibration coefficient 1 N K,Q0 : ____________ mGy/nC mGy/reading<br />

Reference<br />

conditions:<br />

HVL (mm Al): ________<br />

Pressure P 0 (kPa): _____<br />

Field size (mm × mm): ____________<br />

Temperature T 0 ( o C): ____<br />

Manufacturer of phantom: __________________________________<br />

Serial No.: _________.<br />

3. Exposure conditions<br />

□ AEC □ Manual AEC setting:______ mA setting:________ Tube voltage (kV): ___<br />

Manual or (if available) post-exposure mA·s: _________<br />

1<br />

This is the calibration coefficient for the whole dosimeter, including the detector and<br />

the measurement assembly. For systems with separate calibration coefficients for the detector<br />

and measurement assembly, the overall calibration coefficient is calculated as a product of the<br />

two separate calibration coefficients.<br />

178

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