Long-term stability of beam quality and output of conventional X-ray units

Conventional diagnostic X-ray units are used for radiographic imaging in many countries. For obtaining entrance surface doses, a numerical dose determination method has been applied in Japan. Although this technique is effective, it has to account for errors, particularly fluctuations, due to the beam quality and output of X-ray tubes. As a part of our quality control procedures, we recorded the entrance surface air kerma, tube voltage, and half-value layer measurements made for four diagnostic X-ray tubes over a 103-week period. The entrance surface air kerma for one of the four X-ray tubes had increased significantly by 11.4 % over 1 year from its initial setting, whereas the tube voltages and half-value layers did not deviate significantly from their initial values. Medical physicists and radiological technologists should be aware of this fluctuation for diagnostic X-ray tubes and take it into consideration when calculating the entrance surface air kerma.