Page 1 of 140

Dose Reconstruction from Occupational 

Medical X-Ray Procedures

ORAUT-OTIB-0006 Rev. 06 

Effective Date: 09/27/2019

Supersedes: Revision 05 

Subject Expert(s): Robert C. Winslow

Document Owner 

Approval: Signature on File

Robert C. Winslow, Document Owner

Approval Date: 09/20/2019

Concurrence: Signature on File

John M. Byrne, Objective 1 Manager

Concurrence Date: 09/22/2019

Concurrence: Signature on File

Scott R. Siebert, Objective 3 Manager

Concurrence Date: 09/20/2019

Concurrence: Vickie S. Short Signature on File for

Kate Kimpan, Project Director

Concurrence Date: 09/23/2019

Approval: Signature on File

Timothy D. Taulbee, Associate Director for Science

Approval Date: 09/27/2019

FOR DOCUMENTS MARKED AS A TOTAL REWRITE, REVISION, OR PAGE CHANGE, REPLACE THE PRIOR 

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION.

New Total Rewrite Revision Page Change
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 2 of 140

 

PUBLICATION RECORD

EFFECTIVE

DATE

REVISION

NUMBER DESCRIPTION

11/14/2003 00 New document to establish the technical basis for the development 

of a generic document to use to perform dose reconstruction from 

occupationally related diagnostic X-ray procedures. First approved 

issue. Initiated by Judson L. Kenoyer.

12/08/2003 01 Revision that limits the use of this document to post 1970. Approved 

issue of Revision 01. Initiated by Judson L. Kenoyer

12/29/2003 02 Revision that includes information to reinstate the ability for the 

document to cover exposures pre-1970. Approved issue of 

Revision 02. Initiated by Judson L. Kenoyer

08/02/2005 03 Revision to add photofluorography use table and lumbar spine Xrays. Deleted footnote b and adjusted footnote references in 

Table 8. Approved issue of Revision 03. No retraining required. 

Initiated by Vernon E. Shockley and Ronald L. Kathren.

12/21/2005 03 PC-1 Approved page change revision. Page change initiated to 

incorporate recent direction from NIOSH to include DOL review 

comments on page 8. Deletes two obsolete paragraphs on page 8 in 

Section 1.0. Corrects table number reference on page 20 in 

Section 4.0. No sections were deleted. No retraining is required. 

Initiated by Vernon E. Shockley and Ronald L. Kathren.

Signature on File 12/14/2005

Judson L. Kenoyer, Task 3 Manager

Signature on File 12/14/2005

Kate Kimpan, Projector Director

Signature on File 12/21/2005

James W. Neton, Associate Director for Science

06/11/2011 04 Revision to add organ dose data from lordotic and oblique chest 

X-rays, chest fluoroscopy, thoracic and cervical spine X-rays, and 

skin doses for all procedures. Lists additional references in the 

Reference Section. Incorporates formal internal and NIOSH review 

comments. Also addresses an additional NIOSH comment. 

Constitutes a total rewrite of the document. Training required: As 

determined by the Objective Manager. Initiated by Elyse M. Thomas.
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 3 of 140

EFFECTIVE

DATE

REVISION

NUMBER DESCRIPTION

08/13/2018 05 Draft revision initiated to add guidance for organ to be used based on 

ICD-9 code in Attachment B. Renumbered figures, tables, and 

equations. Changed part thickness in Table 3-1 for anterior-posterior 

and posterior-anterior projections to 24 cm, except the cervical spine. 

Added dose for bone surface anterior-posterior lordotic in Table B-7 

for 1971 to 1985. Corrected Table B-10 entrance skin dose through 

1970 for anterior-posterior and lateral lumbar spine to account for 

proper backscatter factor. Corrected Table B-11 through 1970 for 

anterior-posterior and lateral projections that assigned 100% or 10% 

entrance skin dose to reflect changes in Table B-10. Corrected 

Table B-11 lateral lumbar spine through 1970 for back torso:

buttocks (iliac crest and below) to include E−02. Corrected Table 

B-13 fourth column title to left posterior oblique thoracic spine. 

Corrected Table B-1 to B-3 anterior-posterior lordotic chest dose 

conversion factors and added footnote. Latest references and SRDB 

numbers have been updated in References section. Incorporates 

formal internal and NIOSH review comments. Attachments A and B 

swapped. Tables in Attachment B were rearranged and renumbered 

to match text callout order. Constitutes a total rewrite of the 

document. Training required: As determined by the Objective 

Manager. Initiated by Robert C. Winslow.

09/27/2019 06 Revision initiated to incorporate ICD-10 codes. Additional 

clarification of citation for information to address SC&A comments. 

Incorporates formal internal and NIOSH review comments. 

Constitutes a total rewrite of the document. Training required: As 

determined by the Objective Manager. Initiated by Robert C. 

Winslow.
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TABLE OF CONTENTS

SECTION TITLE PAGE

Acronyms and Abbreviations ............................................................................................................... 7

1.0 Introduction .............................................................................................................................. 9

2.0 Purpose and Scope.................................................................................................................. 9

3.0 Technical Factors that Affect Medical X-Ray Dose................................................................... 9

3.1 Kilovoltage, Filtration, and Type of High-Voltage Generator ....................................... 10

3.2 Current and Exposure Time........................................................................................ 12

3.3 Distance ..................................................................................................................... 12

3.4 Collimation.................................................................................................................. 13

3.5 Screens, Grids, and Other Factors ............................................................................. 15

4.0 Determining Incident Air Kerma.............................................................................................. 15

4.1 Using Beam Measurements ....................................................................................... 15

4.2 Using Technical Factors ............................................................................................. 16

4.3 Using Published Values from Medical Literature......................................................... 16

5.0 Determining Dose Equivalent to Organs Other Than Skin...................................................... 18

5.1 ICRP 34 Organ Dose Conversion Factor for Organs not explicitly given in ICRP 

34 ............................................................................................................................... 18

5.2 Poor Collimation and the Choice of ICRP 34 Dose Conversion Factors ..................... 20

6.0 Determining Dose Equivalent to Skin ..................................................................................... 20

6.1 Entrance Skin Dose Equivalent .................................................................................. 24

6.2 Exit Skin Dose Equivalent........................................................................................... 24

6.3 Skin Outside but Near Primary Beam ......................................................................... 24

6.4 Remote Skin Dose Equivalent .................................................................................... 24

7.0 Types and Frequency of X-Ray Screening............................................................................. 25

7.1 Radiographic Chest.................................................................................................... 26

7.2 Photofluorographic Chest ........................................................................................... 27

7.3 Chest Fluoroscopy...................................................................................................... 29

7.4 Lumbar Spine ............................................................................................................. 31

7.5 Pelvis.......................................................................................................................... 33

7.6 Thoracic and Cervical Spine....................................................................................... 34

7.7 Chronic Lymphocytic leukemia ................................................................................... 38

8.0 Uncertainty Analysis for Occupational Medical X-Ray Doses ................................................. 38

9.0 X-Ray Dose Assignment by ICD-10 Code.............................................................................. 40

10.0 Attributions and Annotations .................................................................................................. 40

References ........................................................................................................................................ 41

ATTACHMENT A SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES....................... 47

ATTACHMENT B ORGAN DOSE EQUIVALENT TABLES........................................................ 109
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LIST OF TABLES

TABLE TITLE PAGE

3-1 Relationship of technical factors to X-ray beam output........................................................... 10

3-2 Standard body dimensions, SIDs, and SSDs used for dose reconstruction............................ 13

4-1 Published incident air kerma values by procedure and period................................................ 17

5-1 ICRP Publication 60 organs used for estimation of external dose which do not have 

ICRP Publication 34 DCFs for calculating occupational medical dose.................................... 20

5-2 DCFs for poorly collimated chest beams through 1970 .......................................................... 22

5-3 DCFs for poorly collimated spine and pelvis beams through 1970 ......................................... 23

7-1 Typical protocols for thoracic and cervical spine examinations through 1970......................... 35

7-2 Relevant technical factors for cervical spine projections......................................................... 36

7-3 Summary table of distribution parameters for CLL.................................................................. 38

8-1 Adult body thickness from literature ....................................................................................... 40

A-1 Selection of organs for X-ray dose assignment during dose reconstruction based on 

ICD-10 code...........................................................................................................................48

A-2 Selection of organs for chest X-ray dose assignment through 1970 based on ICD-10 

code when referred from Table A-1 ........................................................................................ 87

A-3 Selection of organs for chest X-ray dose assignment after 1970 based on ICD-10 code 

when referred from Table A-1 ................................................................................................ 96

A-4 Selection of organs for lumbar spine X-ray dose assignment based on ICD-10 code 

when referred from Table A-1 .............................................................................................. 104

A-5 Selection of organs for thoracic spine X-ray dose assignment based on ICD-10 code 

when referred from Table A-1 .............................................................................................. 105

A-6 Selection of organs for cervical spine X-ray dose reconstruction based on ICD-10 code 

when different organ selection is required based on view..................................................... 107

B-1 DCFs used in determining dose equivalents from thoracic and cervical spine projections 

through 1970........................................................................................................................ 110

B-2 DCFs used in determining dose equivalents for chest projections through 1985 .................. 111

B-3 DCFs used in determining dose equivalents for chest projections 1986 and later, and for 

lumbar spine and pelvis for all periods ................................................................................. 112

B-4 Skin dose guidance for chest projections for the poor collimation period through 1970........ 113

B-5 Skin dose guidance for lumbar spine and pelvis projections for the poor collimation 

period through 1970............................................................................................................. 115

B-6 Skin dose guidance for thoracic spine projections for the poor collimation period through 

1970..................................................................................................................................... 117

B-7 Skin dose guidance for cervical spine projections for the poor collimation period through 

1970..................................................................................................................................... 119

B-8 Skin dose guidance for chest projections for the good collimation period after 1970 ............ 121

B-9 Skin dose guidance for lumbar spine projections for the good collimation period after 

1970..................................................................................................................................... 123

B-10 Organ dose equivalents for chest projections for all periods................................................. 125

B-11 Skin dose equivalents from chest projections through 1970................................................. 128

B-12 Skin dose equivalents from various chest projections after 1970.......................................... 130

B-13 Organ dose equivalents for lumbar spine and pelvis projections for all periods .................... 132

B-14 Skin dose equivalent from lumbar spine and pelvis projections for all periods...................... 134

B-15 Organ dose equivalents for thoracic and cervical spine projections through 1970................ 136

B-16 Skin dose equivalent from thoracic and cervical spine projections through 1970.................. 139
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LIST OF FIGURES

FIGURE TITLE PAGE

3-1 Diagram of poor collimation.................................................................................................... 14

5-1 Diagram of the torso...............................................................................................................19

7-1 Essential components of a PFG unit ...................................................................................... 28

7-2 Typical General Electric PFG system..................................................................................... 28

7-3 Diagram of non-image-intensified fluoroscopy........................................................................ 31

7-4 Beam areas in relation to body anatomy for the AP lumbar spine .......................................... 33

7-5 Beam areas in relation to body anatomy for the AP pelvis...................................................... 35

7-6 Beam areas in relation to body anatomy for the AP thoracic spine......................................... 35

7-7 Beam areas in relation to body anatomy for the LAT cervical spine ....................................... 37
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 7 of 140

ACRONYMS AND ABBREVIATIONS

AP anterior-posterior

AWE atomic weapons employer

C coulomb

CFR Code of Federal Regulations

cGy centigray

cm centimeter

cSv centisievert

DCF dose conversion factor

DOE U.S. Department of Energy

DOL U.S. Department of Labor

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 2000

ENSD entrance skin dose

eq. equivalent

ESE entrance skin exposure

EXSD exit skin dose

Gy gray

HE effective dose equivalent

HVL half-value layer

ICD-10 International Statistical Classification of Diseases and Related Health Problems, Tenth 

Edition

ICRP International Commission on Radiological Protection

in. inch

J joule

Ka,i incident air kerma

keV kiloelectron-volt

kg kilogram

kVp kilovolts-peak

LAO left anterior oblique

LAT lateral

LPO left posterior oblique

m meter

mA milliampere

mAs milliampere-second

mGy milligray

min minute

mm millimeter

mR milliroentgen

mrad millirad

mrem millirem

NCRP National Council on Radiation Protection and Measurements
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NIOSH National Institute for Occupational Safety and Health

OBL oblique

ORAUT Oak Ridge Associated Universities Team

ORNL Oak Ridge National Laboratory

PA posterior-anterior

PFG photofluorography

R roentgen

RAO right anterior oblique

RPO right posterior oblique

RSD remote skin dose

s second

SID source-to-image distance

SRDB Ref ID Site Research Database Reference Identification (number)

SSD source-to-skin distance

Sv sievert

TB tuberculosis

TIB technical information bulletin

U.S.C. United States Code

§ section or sections
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 9 of 140

1.0 INTRODUCTION

Technical information bulletins (TIBs) are not official determinations made by the National Institute for 

Occupational Safety and Health (NIOSH) but are rather general working documents that provide 

historical background information and guidance to assist in the preparation of dose reconstructions at 

particular sites or categories of sites. They will be revised in the event additional relevant information 

is obtained about the affected site(s). TIBs may be used to assist NIOSH staff in the completion of 

individual dose reconstructions.

In this document, the word “facility” is used as a general term for an area, building, or group of 

buildings that served a specific purpose at a site. It does not necessarily connote an “atomic weapons 

employer facility” or a “Department of Energy (DOE) facility” as defined in the Energy Employees 

Occupational Illness Compensation Program Act of 2000 [42 U.S.C. § 7384l(5) and (12)].

2.0 PURPOSE AND SCOPE

The purpose of this TIB is to describe medical X-ray dose reconstruction in general, and to provide 

organ dose equivalents that can be used complex-wide when site-specific information is specious or 

not available.

“External doses from occupational X-ray screening procedures that were provided to the energy 

employee as a condition of employment and were performed at a covered facility must be included in 

dose reconstruction. X-rays performed for diagnostic or therapeutic reasons, however, are excluded. 

Screening X-rays are systematic examinations that are performed on asymptomatic people without 

history, complaint, physical findings, or physician evaluation. Diagnostic X-rays are careful 

examinations of people who already have suspicious signs or symptoms of a potential condition, and 

they are performed after physician evaluation.” (NIOSH 2010). Therapeutic X-rays are used to treat 

cancer and other conditions, not as an aid to diagnosing those conditions.

Many DOE and atomic weapons employer (AWE) sites had their own medical clinics and equipment 

to perform medical X-ray screening of their workers. Sometimes, however, the sites contracted with 

offsite private physicians’ offices, clinics, or local community hospitals to provide this service to 

workers (ORAUT 2017). NIOSH has determined that EEOICPA defines covered exposure as the 

radiation a covered employee received at a covered facility during a covered period (NIOSH 2010). 

Therefore, screening X-rays taken at offsite facilities that are not covered facilities are not included in 

the dose reconstruction.

Attributions and annotations, indicated by bracketed callouts and used to identify the source, 

justification, or clarification of the associated information, are presented in Section 10.0.

3.0 TECHNICAL FACTORS THAT AFFECT MEDICAL X-RAY DOSE

A number of factors determine the dose to the worker from an X-ray procedure. These factors include 

the X-ray machine settings (typically called technique factors) used for the exposure, such as the 

kilovoltage (or the kilovolts-peak, kVp), the beam current in milliamperes (mA), and time of exposure 

(seconds). Other factors that can affect the dose to the worker are the X-ray source-to-image 

distance (SID), where the X-ray source is defined as the focal spot or target of the X-ray tube, the 

amount of filtration in the machine, the size of the X-ray beam (collimation), the type of high-voltage 

generator, the type and speed of the film and screens, the film development procedure, the use of 

grids, and the physical size of the worker. The effect of these factors on dose reconstruction is 

discussed in the following sections.
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The dose to workers can be estimated with a reasonable degree of accuracy by several methods, 

depending on what is known about the specific X-ray machine. Direct measurements of the X-ray 

beam itself can be used to determine dose to the worker from an X-ray procedure. Dose can also be 

determined using knowledge of the technique factors used on a given X-ray machine along with 

standard X-ray output tables in the open literature. Using either direct X-ray beam measurements or 

known technique factors obviates the need for detailed knowledge of some of the other factors that 

can affect dose. For example, the technique factors should include adjustments for the type and 

speed of the film and screens, film development, and use of grids. The uncertainty in the dose from 

many of these factors, including the uncertainty in the size of the worker, is discussed in Section 8.0. 

Table 3-1 provides a summary of the effect of various technical factors on the radiation output. 

Sections 3.1 through 3.5 discuss these factors in more detail. 

Table 3-1. Relationship of technical factors to X-ray beam output. 

Parameter Units Relationship to X-ray beam output

Kilovoltage kV Air kerma proportional to 1.7 power of kVp

Tube current mA Air kerma proportional to tube current

Exposure time s Air kerma proportional to exposure time

Filtration mm Al Air kerma decreases by ~40% for each additional mm Al added to the beam

Distance cm or in. Air kerma decreases by inverse square relationship

3.1 KILOVOLTAGE, FILTRATION, AND TYPE OF HIGH-VOLTAGE GENERATOR

The maximum energy of the X-ray beam is determined by the voltage applied between the cathode 

and anode of the X-ray tube. Increasing the kVp increases the maximum energy of the X-ray photons 

and, therefore, the ability of the X-ray photons to penetrate thicker body parts. Increasing the kVp 

increases the beam output, defined as the quotient of the air kerma at a specified distance by the 

product of tube current and exposure time in units of Gy/mAs (ICRU 2005). Numerous empirical 

studies of beam output as a function of kVp over the years show that increasing the kVp increases the 

beam output according to the 1.7 power of the kilovoltage for a given amount of filtration (Handloser 

and Love 1951; Trout, Kelley, and Cathey 1952; BRH 1970). In the absence of specific 

measurements or empirical data, this relationship can be used to determine or adjust the beam output 

as a result of changes in kilovoltage.

The X-rays from a medical X-ray machine are predominantly of bremsstrahlung origin and, therefore, 

exit the beam port with a spectrum of energies. It is difficult to know the precise energy spectrum of 

an X-ray beam from a particular X-ray machine, so in practice it is common to refer to the “beam 

quality” as a simple surrogate for detailed information about the energy spectrum (ICRU 1937). The 

beam quality is a measure of the ability of the beam to penetrate matter (also known as beam 

hardness), and is expressed in terms of the half-value layer (HVL) of the beam in millimeters of 

aluminum. The beam quality and the HVL are primarily a function of the target material, kVp, and 

total filtration in the X-ray machine. Some knowledge of the beam quality is necessary for dose 

reconstruction. Ideally, machine-specific HVL measurements are available. Without actual HVL 

measurements, estimates of the HVL can be made with knowledge of the kVp and total filtration in the 

machine, which is the sum of the inherent filtration in the tube itself and any added filtration.

All X-ray tubes have inherent filtration, which includes the window, aperture, or port in the tube 

enclosure through which the X-ray beam passes or emerges from the X-ray tube. The tube housing is 

shielded to eliminate leakage radiation from the tube other than through the port. In medical X-ray 

machines for radiographic imaging, the window or beam port through which the useful beam emerges 

is purposely made very thin, typically equivalent to 0.5 mm Al in attenuation, and so provides little 

beam hardening. It was recognized early that placing additional filters in the X-ray beam to 

preferentially absorb the lower energy X-rays in the spectrum while allowing the higher energy X-rays 
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to pass through had the potential to reduce the skin dose to the individual being radiographed. For 

this reason, minimum filtration requirements for medical X-ray machines have been in existence for a 

long time. 

Recommendations were made in 1937 by the International Committee for Radiological Units and 

Measurements (ICRU 1937), which specified aluminum filters for X-rays produced from 20 to 

120 kVp. The 1936 recommendation of the U.S. Advisory Committee on X-Ray and Radium 

Protection, the forerunner of the National Council on Radiation Protection and Measurements 

(NCRP), called for total filtration (permanently mounted) of 0.5 mm Al equivalent (eq.) for radiographic 

installations, and 1 mm Al eq. for fluoroscopy (NBS 1936). Typical added filtration in the 1940s 

ranged from zero to 1 mm Al. In 1949, the National Bureau of Standards recommended an additional 

1 mm of Al filtration for radiography of thick parts of the body such as the chest (NBS 1949). In 1955, 

the recommendation for medical radiographic machines called for 2.5 mm Al eq. total filtration (NBS 

1955). The recommended total filtration remained at 2.5 mm in 1968 for medical radiographic 

machines operating above 70 kVp (NCRP 1968). For machines already in operation, these 

recommended filter thicknesses might not have been used for some time after the date of the 

recommendation. Since 1974, X-ray machine manufacturers have been required by law to include 

minimum amounts of filtration (21 CFR Part 1020). In this TIB, an HVL of 2.0 mm Al is assumed for 

determination of dose equivalent from chest fluoroscopy, lumbar spine, thoracic spine, cervical spine, 

and pelvis X-rays, 2.5 mm Al for chest X-rays taken through 1985, and 4.0 mm Al for X-rays taken 

after 1985.

The relationship of beam output to kVp and to filtration is complex, to some extent machine-specific, 

and best determined empirically. However, in the absence of empirical data for a specific machine, 

adequate contemporary empirical and theoretical data exist on which to determine the machine output 

with a reasonable degree of certainty. For a given mAs setting on a machine, additional filtration 

generally reduces the air kerma in an exponential manner. For a typical single-phase X-ray machine 

operating in the range of 80 to 100 kVp, each additional millimeter of Al filtration effects a reduction of 

about 40% in the air kerma (Trout, Kelley, and Cathey 1952; Taylor 1957). Therefore, the 

approximate reduction in air kerma afforded by any thickness of Al filtration can be determined by the 

following exponential equation:

(3-1)

( )

0.4

0

0

or

ln / 0.4

t I Ie

II t

− =

= −

where t is the thickness of Al in millimeters, and I and I0 are air kerma with and without the filter, 

respectively. In the absence of specific measurements or empirical data, this correction can be 

applied to determine the effect of filtration on air kerma.

The effects of filtration and kVp tend to offset one another; the addition of filtration reduces the air 

kerma per mAs, while increasing the kVp increases the air kerma per mAs. Higher kVp radiographic 

techniques typically require fewer mAs per radiograph, and result in lower entrance skin dose

(ENSD), but might increase dose to organs at greater depths in the body. 

High-voltage X-ray generators for medical radiography since the 1940s have been of three basic 

types: (1) single-phase full-wave-rectified, typical of virtually all medical radiographic units used

through the mid-1980s; (2) three-phase; and (3) high frequency. A single-phase full-wave-rectified

generator produces 120 half-sinusoidal pulses of X-rays per second, each with a duration of 1/120 

second, with a 100% fluctuation in the voltage. A three-phase generator uses three single-phase 

voltage lines, each slightly out of phase with the others, producing a more constant (i.e., less 
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fluctuating) voltage (Selman 1965, p. 5) and therefore a greater beam output (approximately 20%) in 

comparison with a single-phase full-wave-rectified machine operating at the same kVp and mAs. 

Three-phase generators were primarily installed in hospitals because they were expensive and 

required three-phase wiring. A high-frequency generator is the most modern type and produces a 

voltage waveform with very little fluctuation (2%) in voltage to the X-ray tube (Amman 1991, p. 10). 

Three-phase high-frequency machines did not become commonplace until the 1980s and 1990s. For 

dose reconstruction and in the absence of evidence to the contrary, X-ray machines will be assumed 

to be single-phase full-wave-rectified.

3.2 CURRENT AND EXPOSURE TIME

The “current” in an X-ray tube refers to the number of electrons accelerated across the evacuated 

volume of the X-ray tube, flowing from the cathode to the anode. For a given kilovoltage, the number 

of X-ray photons and the air kerma are directly proportional to the X-ray tube current. “Exposure time” 

refers to the time the beam is on or that the machine is producing X-rays. As with the tube current, 

the number of X-ray photons and the air kerma are directly proportional to the exposure time for a 

given kilovoltage. The exposure necessary for a radiograph is typically specified in terms of mAs, the 

product of X-ray tube current, and the exposure time. All other factors being equal (e.g., kVp, 

filtration, development, film/screen combination), air kerma is proportional to the mAs.

To avoid or minimize image blurring from involuntary organ motion such as the beating heart, 

exposure time is minimized, and the current proportionately increased to obtain the desired amount of 

radiation for a properly exposed radiograph. Earlier medical X-ray machines were equipped with 

mechanical timers whose accuracy was not as good as the accuracy of the electronic timers on later 

machines. Gross bias errors in timer accuracy are unlikely in that these would have resulted in overor underexposure of the radiograph and, thus, would have been quickly detected and corrected. 

Small random errors in the timers might not have been visible on radiographs, but might have 

produced uncertainties of perhaps ±20% in the air kerma. 

3.3 DISTANCE

X-ray beam output is a function of distance from the source of X-rays in the tube, approximating the 

inverse square law at large distances (i.e., more than a few tens of centimeters) from the tube. Chest 

radiographs are taken at a standard SID of 72 in. (183 cm) between the source and the plane of the 

film. Most other radiographs are taken at a standard SID of 36 in. to 40 in. (102 cm). The distance 

between the source and the worker’s body, expressed as the source-to-skin distance (SSD), is 

smaller than the SID because the worker is positioned between the source and the film cassette. 

The air kerma at the point where the X-ray beam enters the body, known as the incident air kerma 

(Ka,i) (ICRU 2005), is a reference point for determining organ dose (see Equation 4-1 in Section 4.1). 

The Ka,i depends on the SID for the X-ray procedure, the body thickness of the person being 

radiographed, and the thickness of the film holder. While the size of the worker clearly affects the Ka,i, 

individual measurements (such as chest thickness) or individual technique factor settings (kVp, mA, 

and time) were rarely recorded at the time each X-ray was performed on a given worker. This is true 

not only at EEOICPA sites, but also at any other clinical facility for the same period. In addition, the 

organ dose conversion factors (DCFs) from International Commission on Radiological Protection 

(ICRP) Publication 34 (ICRP 1982), which are used to calculate organ-specific doses from incident air 

kerma, are based on assumed standard body dimensions (Cahoon 1961; Wochos, Detorie, and 

Cameron 1979; Kereiakes and Rosenstein 1980). As a result, occupational medical X-ray dose 

reconstruction is based on standard body dimensions and cannot be claimant-specific. 

Table 3-2 provides the standard SIDs for the more common X-ray screening procedures and the 

commonly accepted thicknesses of the involved body parts. It also provides the calculated SSDs for 
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dose reconstruction assuming a standard 5 cm between the point where the X-ray beam exits the 

body and the plane of the film to account for the thickness of the cassette and/or cassette holder

(Kereiakes and Rosenstein 1980, p. 36).

3.4 COLLIMATION

Collimation refers to the limitation of the size of the X-ray beam. In the early years after the discovery 

of X-rays, the philosophy was to use a fairly large aperture (i.e., limited collimation) to ensure that the 

entire area of clinical interest was included in the radiograph. As a result of radiation protection 

Table 3-2. Standard body dimensions, SIDs, and SSDs used for dose reconstruction.

a

Chest

Projection

Part thickness 

(cm)b

Standard SID 

(in/cm)c

Calculated SSD

(cm)d

PA (PFG) 24 40/102e 73

PA 24 72/183 154

LAT 34 72/183 144

OBL 34 72/183 144

AP lordotic 24 72/183 154

Lumbar spine

Projection

Part thickness 

(cm)b

Standard SID 

(in/cm)c

Calculated SSD

(cm)d

AP and spot 24 40/102 73

LAT and spot 34 40/102 63

Thoracic spine

Projection

Part thickness 

(cm)b

Standard SID 

(in/cm)c

Calculated SSD

(cm)d

AP 24 40/102 73

LAT 34 40/102 63

OBL 34 40/102 63

Cervical spine

Projection

Part thickness 

(cm)b

Standard SID 

(in/cm)c

Calculated SSD

(cm)d

AP 15 40/102 82

LAT 15 72/183f 153g

OBL 15 40/102 82

Pelvis

Projection

Part thickness 

(cm)b

Standard SID 

(in/cm)c

Calculated SSD

(cm)d

AP 24 40/102 73

a. AP = anterior-posterior; LAT = lateral; OBL = oblique; PA = posterior-anterior; 

PFG = photofluorography.

b. The chest and abdomen are assumed to be 24 cm thick and 34 cm wide. The 

neck is assumed to be 15 cm thick and 15 cm wide (ICRP 110 and 116 voxel 

phantom measurements; ICRP 2009, 2010). 

c. Source: standard SID values from ICRP (1982), Tables A2 to A9.

d. The SSD = SID − Part thickness − 5 cm. A 5-cm gap between the worker and 

the plane of the film is included to account for the thickness of the cassette 

and/or cassette holder.

e. Source: Laughlin et al. (1957), p.19. 

f. The 72-in. SID is used for the LAT cervical spine to reduce magnification

(Bontrager and Lampignano 2005, pp. 3, 4; GE 1956, p. 4).
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 g. The SSD for the LAT cervical spine = 183 cm − 15 cm − 5 cm − 10 cm = 

153 cm. The additional 10 cm accounts for the fact that during the LAT cervical 

spine procedure, the shoulder is up against the cassette holder, and so the side 

of the neck is not actually in contact with the cassette holder, affecting the SSD 

calculation.

concerns, beams began to be better collimated, limiting the exposed area of the body and minimizing 

the dose to organs outside the beam. Limiting the size of the X-ray beam had a beneficial effect on 

the image quality because there was less scatter produced when smaller volumes of tissue were 

exposed. Without collimation, organs normally outside of the primary beam are exposed to the 

primary beam. Figure 3-1 illustrates how poor collimation can unnecessarily irradiate organs outside 

the actual image area on the film.

Figure 3-1. Diagram of poor collimation (Price 1958). 

Beam-limiting cones were widely used for radiography from the 1940s to the 1960s (Cahoon 1961, 

p. 4). The cones produced circular beams, and were gradually replaced by variable aperture 

collimators that produced rectangular beams that more efficiently corresponded to the rectangular 

shape of the film (Cahoon 1961, p. 6). By the early 1960s, techniques were being modified to 

incorporate better methods of collimation. The NCRP, in Report 33 (NCRP 1968), updated its 

guidance on medical X-ray protection, including guidance for restriction of the X-ray beam to the area 

of clinical interest. While many facilities had probably already incorporated the beam limitation 

guidance in NCRP Report 33, some smaller facilities might not have incorporated it into their practices 

for several years.

Wochos, Detorie, and Cameron (1979) analyzed the 1972 to 1975 data from the Nationwide 

Evaluation of X-Ray Trends and found that at some facilities, primarily internal medicine and general 

practitioners, the beam area-to-film area ratio could be as high as 2.0, but noted that this ratio was 

significantly lower at hospitals and radiology facilities where more X-rays were done and 

radiographers were generally better trained. For dose reconstruction, it is assumed that radiographs 

from before approximately 1970 were poorly collimated in comparison with radiographs from after 

1970. If actual dose measurements or inspection of the radiographs from a particular site indicate 

that collimation was used before 1970, the site-specific evidence can be used in the development of 

organ doses in that site’s site profile. However, in the absence of information to the contrary with 

respect to collimation before 1970, a beam area-to-film area ratio of 2.0 is assumed for dose 
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reconstruction through 1970. This ratio would be achieved by exposure of an additional 3 in. in all 

directions around a 14- by 17-in. radiographic film.

An assumption of poor collimation of radiographs through 1970 might necessitate the use of DCFs 

from ICRP Publication 34 (ICRP 1982) other than those for the intended examination, because ICRP 

Publication 34 DCFs are based on properly collimated beams. This is discussed in more detail in 

Section 5.2 of this TIB. The tables in Attachment B of this TIB account for poor collimation of 

radiographs through 1970 and require no further adjustment during application during dose 

reconstruction.

3.5 SCREENS, GRIDS, AND OTHER FACTORS

Several other factors affect the X-ray exposure necessary to obtain a usable radiographic image and, 

therefore, have the potential to affect the dose to the worker. However, detailed knowledge of these 

factors is usually unnecessary for dose reconstruction if beam measurements are available or if the 

machine technical factors of kilovoltage (kVp), time(s), and current (mA) are known along with the 

amount of primary beam filtration. 

The exposure necessary for a suitable radiographic image is a function of the film/screen combination 

speed and development. Underdevelopment of films requires additional exposure to achieve 

satisfactory film density. Intensifying screens are used in the cassette to convert the radiation 

efficiently to light photons that subsequently expose the film. Because film is more sensitive to light 

photons than to X-ray photons, using screens and film in combination can reduce the amount of 

necessary radiation. Film and screen speeds have increased dramatically since the 1940s and are 

one of the reasons that the dose per X-ray procedure generally shows a downward trend over this 

period. 

Grids are devices that are placed in front of the film cassette to absorb scattered radiation before it 

reaches the film. The grid itself consists of very thin lead strips placed so the diverging X-ray photons 

pass between the strips. The strips absorb radiation that is scattered at large angles. Grids are 

typically used to radiograph thick body parts such as the abdomen, lumbar spine and, in recent times, 

the chest. The Potter Bucky diaphragm (also known as a Bucky grid) vibrates back and forth rapidly 

during the exposure, which minimizes the chance the strips will appear on the film image. In any 

case, the above are all factored into the technique factors (i.e., kVp, mA, and time) that are used to 

produce images and, therefore, detailed knowledge of them is not always of importance in dose 

reconstruction. 

4.0 DETERMINING INCIDENT AIR KERMA

One of the essential parameters used to determine organ dose equivalent is the incident air kerma, 

Ka,i (ICRU 2005), which is the air kerma from the primary beam on the central X-ray beam axis at the 

SSD (i.e., at the skin entrance plane). Only the primary radiation incident on the skin, without 

backscattered radiation, is included in the definition of Ka,i (ICRU 2005, p. 28). The incident air kerma 

can be determined from actual X-ray beam measurements, knowledge of technical factors for the 

X-ray machine in question, or by using air kerma values from the literature and correcting to the SSD 

of interest. Each of these is discussed in the following sections. Before the quantity “exposure” 

became obsolete (ICRU 2005), the entrance skin exposure (ESE) was used to describe essentially 

the same quantity as incident air kerma.

4.1 USING BEAM MEASUREMENTS

Use of actual X-ray beam measurements is the simplest and most direct means of determining the 

incident air kerma and is most likely to provide the most accurate estimates of organ dose equivalent 
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from a given machine. Unfortunately, X-ray beam measurements are often unavailable, particularly 

before about 1980. Because actual measurements are the preferred method for determining incident 

air kerma, every effort to determine if such measurements have been made is justifiable. Beam 

measurements are typically quantified in units of roentgens (R) (now obsolete), coulombs per 

kilogram (C/kg), or grays (Gy). Measurements with R-meters and ionization chambers, if properly 

performed, are reliable and have a low degree of uncertainty. In general, the uncertainty of properly 

performed measurements in the energy region of interest should not exceed ±2% of the measured 

value (Kathren and Larson 1969).

Beam measurements in roentgens must be converted to incident air kerma (see Equation 4.1). Using 

the inverse square relationship in Table 3-1 and the standard SSDs from Table 3-2, the air kerma at 

any point on the central axis of the X-ray beam can be converted to the incident air kerma.

( )( )( ) ( ) ( ) (4-1) 4 K R a,i 2.58 10 C/kg/R 33.97J/C 100 cGy/Gy 1Gy/1J/kg − = ×

where

Ka,i = incident air kerma to be used in organ dose calculations (cGy) 

R = exposure in roentgens at the skin entrance plane (i.e., ESE)

2.58 × 10-4 C/kg/R = conversion factor from R to C/kg

33.97J/C = amount of energy required to ionize air

Only the primary radiation incident on the skin, without backscattered radiation, is included in the 

definition of Ka,i (ICRU 2005, p. 28). Therefore, measurements using a phantom would not be 

appropriate for use in the provided equation. 

All information from the sites is evaluated and considered when calculating X-ray doses. While strict 

guidelines for what specifically needs to be known is not provided, any measurement information from 

the sites is to be compared to a calculation using the technical factors to determine if the provided 

values are within reason. In most cases, the Project has not been provided X-ray measurement 

information but has had to rely on technical factors from the sites. 

4.2 USING TECHNICAL FACTORS

In the absence of suitable beam measurements, the incident air kerma can be determined using 

machine-specific technical factors for a given X-ray examination and projection, and for an individual 

with the same dimensions as those in Table 3-2. Technical factors are used with published X-ray 

output data that provide air kerma per mAs as a function of kVp, filtration (or HVL), and distance to 

determine the incident air kerma. X-ray beam output data are available from several publications, 

including NCRP Report 102 (NCRP 1989) and ICRP Publication 34 (ICRP 1982). Table B-3 in NCRP 

Report 102 (p. 56) provides average air kerma rates for medical X-ray equipment operating at various

kVp with 2.5-mm Al eq. filtration at distances from 30 to 183 cm from the source. As an alternative, 

Figure B.1 in NCRP Report No. 102 (p. 61) and Figure A1 in ICRP Publication 34 (p. 44) provide 

graphical representations of air kerma at 100 cm for various values of kVp and filter thickness greater 

than 2.5 mm Al eq. Using these tables or graphs, a reasonable estimate of incident air kerma can be 

obtained with knowledge of the mAs and the SSDs from Table 3-2. 

4.3 USING PUBLISHED VALUES FROM MEDICAL LITERATURE 

If both machine-specific beam measurements and machine-specific technical factors are unknown or 

unreliable, values of incident air kerma from the general medical literature of the time can be used. 

These incident air kerma values are listed in Table 4-1. Published incident air kerma values are 
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values from measurements reported in the literature for similar X-ray machines and X-ray procedures 

and for similar periods. Published incident air kerma values are used to calculate many of the organ 

dose equivalents in this TIB, with a few exceptions where measured doses directly from medical 

literature are used. More detail about some of the incident air kerma values is provided in the 

sections on X-ray procedures.

Table 4-1. Published incident air kerma values by procedure and period.

a

Chest

Projection

HVL

(mm Al eq.) 

through 1970

Incident air 

kerma (cGy) 

through 1970

HVL

(mm Al eq.)

1971–1985

Incident air 

kerma (cGy) 

1971–1985

HVL

(mm Al eq.) 

after 1985 

Incident air 

kerma (cGy) 

after 1985

PFG 2.5 2.27b Not used Not used Not used Not used

PA 2.5 0.20c 2.5 0.10k 4.0 0.05l

LAT 2.5 0.50c 2.5 0.25m 4.0 0.13

OBL 2.5 0.50d 2.5 0.25d 4.0 0.13

AP lordotic 2.5 0.20e 2.5 0.10e Not used Not used

Fluoroscopy (PA) 2.0 2.50f Not used Not used Not used Not used

Lumbar spine

Projection

HVL

(mm Al eq.) 

through 1970

Incident air 

kerma (cGy) 

through 1970

HVL

(mm Al eq.)

1971–1985

Incident air 

kerma (cGy) 

1971–1985

HVL

(mm Al eq.) 

after 1985 

Incident air 

kerma (cGy) 

after 1985

AP and spot 2.0 1.44g 2.5 0.78h Not used Not used

LAT and spot 2.0 3.79g 2.5 2.80h Not used Not used

Thoracic spine

Projection

HVL

(mm Al eq.) 

through 1970

Incident air 

kerma (cGy) 

through 1970

HVL

(mm Al eq.)

1971–1985

Incident air 

kerma (cGy) 

1971–1985

HVL

(mm Al eq.) 

after 1985

Incident air 

kerma (cGy) 

after 1985

AP 2.0 0.985g Not used Not used Not used Not used

LAT 2.0 2.20g Not used Not used Not used Not used

OBL 2.0 2.20i Not used Not used Not used Not used

Cervical spine

Projection

HVL

(mm Al eq.) 

through 1970

Incident air 

kerma (cGy) 

through 1970

HVL

(mm Al eq.)

1971–1985

Incident air 

kerma (cGy) 

1971–1985

HVL

(mm Al eq.)

after 1985

Incident air 

kerma (cGy) 

after 1985

AP 2.0 0.432j Not used Not used Not used Not used

OBL 2.0 0.432j Not used Not used Not used Not used

LAT 2.0 0.261j Not used Not used Not used Not used

Pelvis

Projection

HVL

(mm Al eq.) 

through 1970

Incident air 

kerma (cGy) 

through 1970

HVL

(mm Al eq.)

1971–1985

Incident air 

kerma (cGy) 

1971–1985

HVL

(mm Al eq.)

after 1985 

Incident air 

kerma (cGy) 

after 1985

AP 2.0 1.52g Not used Not used Not used Not used

a. Not used means projection not used for screening in this period.

b. Incident air kerma of 2.27 cGy is for stereo (two-exposure) PFG (Rising and Soldat 1959, p. 7) (see Section 7.2 for 

additional information). 

c. Source: Stanford and Vance (1955, p. 7).

d. Chest OBL assumed to have same incident air kerma as chest LAT projection based on projection through a longer axis 

of the body.

e. Chest AP lordotic assumed to have same incident air kerma as chest PA. 

f. Fluoroscopy dose based on 5 R/min for 30 seconds with an HVL of 2.0 mm Al eq. (see Section 7.3 for additional 

information). 

g. Source: Lincoln and Gupton (1958, pp. 7–8) and Equation 4-1 or 7-1 in this TIB.

h. Source: Kereiakes and Rosenstein (1980, p. 59).
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i. Thoracic spine OBL assumed to have same incident air kerma as thoracic spine LAT projection based on projection 

through a longer axis of the body.

j. Source: Braestrup and Wycoff (1958, p. 81) (see Section 7.6 for additional information). 

k. Source: Rising and Soldat (1959, p. 7) (ESE of 40 mR with additional conservatism to ensure maximum value). 

l. Source: WSDH (1983–2001, p. 4) (ESE of 11 mR with additional conservatism to ensure maximum value). 

m. Chest LAT incident air kerma assumed to be 2.5 times higher than Chest PA incident air kerma (see Section 7.2 for 

additional information). 

5.0 DETERMINING DOSE EQUIVALENT TO ORGANS OTHER THAN SKIN

Attachment A, Table A-1 provides guidance for the organ to which dose is assigned based on the 

International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD10) code. Attachment A is organized to use the ICD-10 code (from the dose reconstruction claim) to 

determine the organ for which medical X-ray dose will be assigned. Table A-1 provides the organ to 

be used for PFG and chest, lumbar spine, thoracic spine, cervical spine, and pelvis medical X-ray 

dose assignment. Tables A-2 through A-5 provide additional guidance for organ selection when 

different organs are appropriate for different views.

To conserve space in this document, a simplification to Tables A-1 through A-4 has been made when 

all subcodes of any specific code have the same X-ray organ for the X-ray procedures defined for 

those codes. In such cases, the subcodes have been collapsed to the single higher code in the table 

and the listed organs and models are to be used for that code and all subcodes with additional 

extensions.

The method from ICRP Publication 34 (ICRP 1982) was used to estimate many organ dose 

equivalents. This methodology is based on Monte Carlo calculations for a reference adult in 

Kereiakes and Rosenstein (1980, Table 94 and Figures 2 and 3) that appear to be more 

representative of the human body than the simple nonstandardized phantoms used in the 1950s for 

early studies on gonad dose to the population (Lincoln and Gupton 1958; Laughlin et al. 1957; 

Billings, Norman, and Greenfield 1957). In the Publication 34 method, organ dose is obtained as the 

product of entrance kerma and the selected DCF from Tables A2 to A8. Entrance kerma is defined in 

Publication 34 as “air kerma in air without backscatter.” For consistency in this TIB, the term incident 

air kerma (Ka,i) from ICRU (2005) is used:

(5-1) , ( )( )(1 cSv/cGy)(1 rem/cSv) ODE K DCF = a i

where

ODE = organ dose equivalent (rem) 

Ka,i = incident air kerma (cGy) 

DCF = selected ICRP 34 organ-specific DCF

1 cSv/cGy = conversion from absorbed dose to dose equivalent for X-ray photons; 1 cSv = 1 

rem

Selection of the appropriate DCF from Tables A2 to A8 in ICRP Publication 34 (ICRP 1982) requires 

knowledge of the X-ray projection, the organ, and the X-ray beam quality in terms of the HVL in 

mm Al. If the kVp and total filtration are known, HVLs can be estimated from the data in Tables A16 

and A17 of ICRP Publication 34 (p. 44) or Table B.2 in NCRP Report 102 (NCRP 1989, p. 56).

5.1 ICRP 34 ORGAN DOSE CONVERSION FACTOR FOR ORGANS NOT EXPLICITLY GIVEN 

IN ICRP 34

Tables A2 to A8 in ICRP Publication 34 (ICRP 1982) provides average absorbed dose per entrance 

air kerma for seven specific organs. Additional organs are used in this document that correspond to 
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the likely primary cancer site locations used in dose reconstruction. Therefore, a substitute DCF must 

be selected for organs for which there is no corresponding DCF in ICRP Publication 34. For a 

properly collimated beam, the substitute DCF is usually selected according to anatomical proximity, 

with due consideration to other factors such as whether one or both organs are inside or outside the 

primary beam, organ depth, characteristics of overlying tissue, etc. Figure 5-1 illustrates the 

relationships between the locations of organs.

In general, for chest, thoracic, and cervical spine X-rays with properly collimated beams, the lung 

DCF is used for other organs in the thoracic or upper abdominal cavity (i.e., thymus, esophagus, 

stomach, small intestine, and liver/gallbladder/spleen). Because an appreciable fraction of the 

skeleton is in the trunk, in particular the trabecular bone, which has a large surface-to-volume ratio, 

and the sternum, which is a primary location of the red marrow in the adult, the lung DCF is used to 

determine the dose to bone surfaces for chest, thoracic, and cervical spine X-rays. When the lung 

DCF is used as a substitute for other organs, the higher of the male or female lung DCF is used to 

determine the dose to these other organs for either gender. Using the same logic, the ovary DCF is 

used as a substitute to determine the dose to organs in the lower abdomen such as the urinary 

bladder, prostate, and colon/rectum, regardless of gender. For the lumbar spine and pelvis X-rays, 

the ovary DCF is used as a substitute to determine the dose to the liver, gallbladder, spleen, urinary 

bladder, prostate, colon, rectum, stomach, bone surfaces (in the spine and pelvis), and the remainder 

organs, again regardless of gender. The thyroid DCF is usually selected as the substitute to 

determine the dose to the eye/brain. Exceptions to the general substitutions in Table 5-1 are 

footnoted.

Figure 5-1. Diagram of the torso (Beers 2003, Section 1, Chapter 1). 
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Table 5-1. ICRP Publication 60 organs used for estimation 

of external dose which do not have ICRP Publication 34 

DCFs for calculating occupational medical dose.a

ICRP Publication 60 

External Dose Organb 

ICRP 34

Organ DCF

Thymus,

Esophagus

Lung

Stomach,

Bone surface, 

Liver/gallbladder/spleen, 

Remainder organs

Lungc or ovary

Urinary bladder/prostate

Colon/rectum

Ovary

Eye/brain Thyroid

a. Applies to most properly collimated chest radiographic procedures.

b. Attachment A provides appropriate ICRP 60 organ based on ICD10 code.

c. The ovary is used as the substitute DCF for these organs for the 

pelvis or lumbar spine imaging. 

5.2 POOR COLLIMATION AND THE CHOICE OF ICRP 34 DOSE CONVERSION FACTORS

Without good collimation, organs normally outside the primary beam are exposed to the primary 

beam. This necessitates the use of DCFs from ICRP Publication 34 (ICRP 1982) other than those for 

the intended procedure, because Publication 34 assumes properly collimated beams. For example, 

the thyroid is normally assumed to be outside the properly collimated beam of a PA chest projection 

(DCF = 32 mGy/Gy for HVL of 2.5 mm Al) (ICRP 1982, Table A2). However, a poorly collimated PA 

chest beam is about 2.0 times the size of the film (Section 3.4); therefore, it is assumed to include the 

thyroid in the primary beam. The dose to the thyroid can then be reasonably estimated by using a 

DCF for a projection in which the thyroid is clearly in the primary beam, such as the anterior-posterior 

(AP) cervical spine projection (DCF = 868 mGy/Gy for HVL of 2.5 mm Al) (ICRP 1982, Table A2). 

However, the thyroid is near the exit surface of the X-ray beam during a PA chest projection and near 

the entrance surface of the beam during an AP cervical spine projection. A simple depth dose 

correction can be applied to the AP cervical spine DCF to account for the additional tissue attenuation 

in the neck when the thyroid is in the primary beam (as it is during an AP cervical spine projection), 

but nearer the exit surface of the beam (as it is during the PA chest projection). Depth dose factors 

from Table B.8 of NCRP Report 102 (NCRP 1989) are used to make this correction. The resulting 

modified thyroid DCF for poorly collimated beams is 174 mGy/Gy assuming the thyroid is 

approximately 10 cm below the surface of the back of the neck, and using a depth dose factor of 0.2 

for 2.5 mm Al HVL from Table B.8 of NCRP Report 102: 868 mGy/Gy × 0.2 = 174 mGy/Gy. 

The DCFs that are selected to determine dose as a result of poor collimation are presented in 

Tables 5-2 and 5-3. They are further discussed in the sections that describe the various screening

procedures and projections. A complete table of DCFs is in Attachment B, Tables B-1 to B-3. 

6.0 DETERMINING DOSE EQUIVALENT TO SKIN

The dose equivalent to the skin surface in the primary beam on the entrance side of the body, called 

ENSD in this TIB, can be calculated with the following equation (Equation 6-1 of Wall, Harrison, and 

Spiers 1988, p.10, with modification for conversion to centisievert): 

( )( ) ( ) ( ) ( ) ( ) (6-1) 1 2

a,i en muscle en air ENSD K μ / ρ μ / ρ BSF d FSD / 1 cSv/cGy −

=
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where

ENSD = dose equivalent at the skin surface (cSv)

Ka,i = incident air kerma (cGy)

(μen/ρ)muscle (μen/ρ)air-1 = ratio of energy absorption coefficients for muscle to air, which is 1.04 to 

1.07 for the 40- to 140-kVp range, usually set to 1 (Wall, Harrison, and 

Spiers 1988)

BSF = backscatter factor from Table B.8 in NCRP Report 102 (NCRP 1989, 

p. 58), which provides backscatter factors for different beam qualities

and field sizes

d = distance dose rate in air taken (cm)

FSD = focus to skin distance (cm)

1 cSv/cGy = the conversion from absorbed dose to dose equivalent for X-ray 

photons; 1 cSv = 1 rem

NOTE: d/FSD is normally equal to 1. This factor would only change if the distance the dose rate is 

measured in air is different than the distance to the entrance skin.
 

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Table 5-2. DCFs for poorly collimated chest beams through 1970.

a,b

Organ of interest PFGc Chest fluoroscopyd

PA chest

through 1970c

LAT/OBL chest

through 1970c

AP lordotic chest

through 1970c

Thyroid Thyroid DCF for AP 

cervical spine corrected 

for depth by 0.2

Thyroid DCF for AP 

cervical spine corrected 

for depth by 0.2

Thyroid DCF for AP 

cervical spine corrected 

for depth by 0.2

Thyroid DCF for LAT skull Thyroid DCF for AP 

cervical spinee 

Eye/brain Thyroid DCF for PA 

chest

Thyroid DCF for PA chest Thyroid DCF for PA chest Thyroid DCF for LAT 

chest

Thyroid DCF for AP 

cervical spine

Ovaries Measuredb Ovaries DCF for PA chest Measuredb Measuredb Ovaries DCF for AP 

abdomen 

Liver/gallbladder/spleen Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Urinary bladder/prostate Measuredb Ovaries DCF for PA chest Measuredb Measuredb Ovaries DCF for AP 

abdomen

Colon/rectum Measuredb Ovaries DCF for PA chest Measuredb Measuredb Ovaries DCF for AP 

abdomen 

Testes Measuredb Testes DCF for PA chest Measuredb Measuredb Testes DCF for AP 

abdomen 

Lungs male Lung DCF male for PA 

chest

Lung DCF male for PA

chest

Lung DCF male for PA 

chest

Lung DCF male for LAT 

chest

Lung DCF male for AP 

chest

Lungs female Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF female for AP 

chest

Thymus Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Esophagus Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Stomach Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Bone surfaces Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Remainder Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for PA 

chest

Lung DCF female for LAT 

chest

Lung DCF male for AP 

chest

Breast Breast DCF for PA chest Breast DCF for PA chest Breast DCF for PA chest Breast DCF for LAT chest Breast DCF for AP chest

Uterus Measuredb Uterus DCF for PA chest Measuredb Measuredb Uterus DCF for AP 

abdomen 

Bone marrow male Bone marrow male for 

PA chest

Bone marrow male for PA 

chest

Bone marrow male for PA 

chest

Bone marrow male for 

LAT chest

Bone marrow male for AP 

chest

Bone marrow female Bone marrow female for 

PA chest

Bone marrow female for 

PA chest

Bone marrow female for 

PA chest

Bone marrow female for 

LAT chest

Bone marrow female for 

AP chest

a. Only substitute DCFs are shown in this table. A complete list of DCFs is in Attachment B, Tables B-1 to B-3. 

b. Measured means that a measured dose from literature provided in Table B-10 is used rather than a DCF.

c. HVL = 2.5 mm Al.

d. HVL = 2.0 mm Al.

e. Cervical spine thyroid DCF used to account for poor collimation.
 

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Table 5-3. DCFs for poorly collimated spine and pelvis beams through 1970 (2.0 mm Al HVL).

a,b

Organ of interest

AP

lumbar spine

LAT

lumbar spine

AP

pelvis

AP

thoracic spine

LAT/OBL 

thoracic spine

AP/OBL 

cervical spine

LAT 

cervical spine

Thyroid Thyroid DCF Thyroid DCF Thyroid DCF Thyroid DCF Thyroid DCF for 

LAT cervical 

spine

Thyroid DCF Thyroid DCF

Eye/brain Thyroid DCF Thyroid DCF Thyroid DCF 10% of thyroid 

DCFc

Thyroid DCF Thyroid DCF Thyroid DCF

Ovaries Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Liver, gallbladder, spleen Measuredb Measuredb Measuredb Lungs male 

DCF

Lung female 

DCF

Lung DCF Lung DCF

Urinary bladder/prostate Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Colon/rectum Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Testes Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Lungs male Lung DCF Lung DCF Lung DCF Lung DCF male Lung DCF male Lung DCF Lung DCF

Lungs female Lung DCF Lung DCF Lung DCF Lung DCF 

female

Lung DCF 

female

Lung DCF Lung DCF

Thymus Lung DCF Lung DCF Lung DCF Lung DCF male Lung DCF 

female

Lung DCF Lung DCF

Esophagus Lung DCF Lung DCF Lung DCF Lung DCF male Lung DCF 

female

Lung DCF Lung DCF

Stomach Measuredb Measuredb Measuredb Lungs male 

DCF

Lung female 

DCF

Lung DCF Lung DCF

Bone surfaces Measuredb Measuredb Measuredb Lungs male 

DCF

Lung female 

DCF

Lung DCF Lung DCF

Remainder Measuredb Measuredb Measuredb Lungs male 

DCF

Lung female 

DCF

Lung DCF Lung DCF

Breast Lung DCFd Lung DCFd Lung DCFd Breast DCF Breast DCF Lung DCFd Lung DCFd

Uterus Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Bone marrow male Bone marrow

DCF

Bone marrow

DCF

Bone marrow 

DCF

Bone marrow 

DCF male

Bone marrow 

DCF male

Bone marrow 

DCF

Bone marrow 

DCF

Bone marrow female Bone marrow

DCF

Bone marrow

DCF

Bone marrow 

DCF

Bone marrow 

DCF female

Bone marrow 

DCF female

Bone marrow 

DCF

Bone marrow 

DCF

a. Only substitute DCFs are shown in this table. A complete table of DCFs is in Attachment B, Tables B-1 to B-3. 

b. Measured means that a measured dose from literature from Table B-13 is used rather than a DCF.

c. See Section 7.6 on thoracic spine and Kereiakes and Rosenstein (1980, p. 52). 

d. ICRP 34 did not compute a breast DCF for these projections. 
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6.1 ENTRANCE SKIN DOSE EQUIVALENT

The ENSD from Equation 6-1 is the starting point for determining other skin dose equivalents. The 

ENSD is assigned to areas of skin in the primary beam on the beam entrance side of the body for a 

particular radiographic projection. Because the area of skin in the primary beam varies with the type 

of radiographic procedure, the projection, and collimation, standard areas of skin were defined for use 

in dose reconstruction. These standard areas are listed in Tables B-4 to B-9 of Attachment B, along 

with areas of skin that are assigned the ENSD for various procedures, projections, and periods.

6.2 EXIT SKIN DOSE EQUIVALENT

The exit skin dose (EXSD) equivalent is the dose equivalent to areas of skin where the X-ray beam 

exits the body. The EXSD is determined by dividing the ENSD by an absorption factor from Table B.7 

in NCRP Report 102 (NCRP 1989, p. 58) to account for attenuation in the body. The selection of an 

absorption factor depends on the beam quality and the thickness (in centimeters) of overlying tissue. 

In this TIB, the standard body dimensions from Table 3-2 are used with the assumed beam qualities 

(2.0, 2.5, and 4.0 mm Al HVL). The absorption factor is decreased by 10% to allow for differences 

between the tabulated values and actual values, as specified in the footnote to Table B.7 in 

Report 102. The areas of skin that are assigned the EXSD for various procedures and projections are 

listed in Tables B-4 to B-9 of Attachment B for various procedures, projections, and periods. 

( ) ( ) (6-2) 1

EXSD ENSD AF 0.9 −=

where

0.9 = uncertainty factor in the tabulated absorption factors

AF = absorption factor from Table B.7 in NCRP Report 102 (NCRP 1989, p. 58)

6.3 SKIN OUTSIDE BUT NEAR PRIMARY BEAM

ENSD and EXSD to portions of the skin outside but near the beam are assumed to be 10% of the 

doses in the neighboring region inside the beam. This is based on the finding that the dose to the 

testes is 10% of the central beam dose when the testes are just outside the beam (Kereiakes and 

Rosenstein 1980, p. 52). The areas of skin that are assigned the 10% of the ENSD or the EXSD are 

listed in Tables B-4 to B-9 of Attachment B for various procedures, projections, and periods.

6.4 REMOTE SKIN DOSE EQUIVALENT

The dose equivalent to areas of skin that are remote from the primary beam (entrance or exit) is 

estimated from the scatter that would be the sole source of irradiation to those areas of skin. The 

dose equivalent to these areas is called the remote skin dose (RSD) in this TIB. The RSD is 

estimated using the following equation:

( ) ( ) ( ) ( )( ) (6-3) 2 RSD ENSD ADD = 1.1 0.0005 1/ r

where

ENSD = ENSD from the primary beam calculated from Equation 6-1 

ADD = average depth dose; percent of the ENSD at a point at the mid-plane of the body 

from Table B.8 in NCRP Report 102 (NCRP 1989, p. 58)

1.1 = correction for differences between the SSD of 60 cm assumed in Table B.8 and 

other SSDs specified in the title of Table B.8 (NCRP 1989, p. 58)
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0.0005 = ratio of scattered to incident exposure at 1 m from a 70-kVp primary beam that 

scatters 90° from the path of the incident X-ray beam from Table B-2 in NCRP 

Report 49 (NCRP 1976, p. 59)

1/r

2 = correction for the distance between the center of the primary beam to the remote 

skin area of interest. The distance is based on the reference adult worker in 

Kereiakes and Rosenstein (1980, Table 94 and Figures 2 and 3). The units for r is 

meters (m).

The distances used for calculation of RSD in this TIB are as follows:

• Chest X-rays and thoracic spine X-rays:

– Skin of thighs to the knees: 0.52 m

– Skin of knees and below: 0.86 m

• Lumbar spine and pelvis X-rays:

– Skin of knee and below: 0.60 m

• Cervical spine X-rays:

– Skin of elbow and below: 0.40 m

– Skin of thigh to the knees: 0.70 m

– Skin of knees and below: 1.00 m

– Torso (front, back, and sides) lowest rib to iliac crest = 0.30 m

– Torso (front, back, and sides) iliac crest and below = 0.50 m

The areas of skin that are assigned the RSD for various procedures and projections are listed in 

Tables B-4 to B-9 of Attachment B.

7.0 TYPES AND FREQUENCY OF X-RAY SCREENING

There is some variability from site to site as to which standard projections were included in screening 

protocols and how frequently they were performed, depending on physician or radiologist preference. 

The standard screening protocols for workers or small subsets of workers should be addressed in 

each Occupational Medical Dose section of the site profile for a particular site. X-ray projections that 

were requested by the physician on a case-by-case basis in addition to the screening protocol fall into 

the diagnostic category (i.e., not screening) and should not be included in dose reconstruction in 

compliance with 42 CFR Part 81, with a few exceptions described in the sections below.

The incidence of technically deficient films that required retakes is not known, but it is likely to have 

been very small, probably no more than a few percent. Trout et al. (1973) in their analysis of the 

rejection rate of chest radiographs from the Coal Mine “Black Lung” program reported an average 

rejection rate of 3% among 67,000 radiographs. This low rejection rate occurred in a program that 

had fairly high standards of training for the radiologists, who interpreted the images, in addition to 

standards for the image quality of the films. It is doubtful that the retake rate in the DOE complex 

would have been higher than this when the standards for the film readers and image quality were not 

formally in place in the DOE complex. Goldman and Beech (1979, p. 44) report that only about 3.64% 

of the examinations at the Baltimore Public Health Service Hospital involved a retake.

In the DOE complex, Los Alamos National Laboratory reported a retake rate of 2.2% in 1998 

(Antonsen 1998, p. 26); Lawrence Berkeley National Laboratory reported a retake rate of 0% in 1991 

(Thomas 1991a, p. 3); no retake program was in place at Lawrence Livermore National Laboratory in 
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1991 (Thomas 1991b, p. 4) or at Brookhaven National Laboratory in 1994 (Bernacki 1994, pp. 13–14). 

These references do not support the automatic inclusion of retakes as an additional source of 

exposure to each worker, but if dose reconstructors encounter records of retakes in individual claim 

file records, the dose from them should be included. 

7.1 RADIOGRAPHIC CHEST

The most commonly performed X-ray screening examination or procedure is the conventional 

radiographic chest projection, which was used in the DOE complex to screen for diseases of the lungs 

and heart, primarily for tuberculosis (TB) and occupational lung diseases like asbestosis (Wirth 1951; 

Cantril 1951). The PA chest projection was standard (Merrill 1949, p. 5) and sometimes accompanied 

by a lateral (LAT) chest projection. The LAT chest was almost always a left LAT (performed with the 

left side of the body towards the film) to image the heart and the aorta (Merrill 1949, p. 10). Both of 

these projections were made on 14-in. by 17-in. film at a standard SID of 72 in. (Merrill 1949, p. 5). 

The PA chest was occasionally performed in stereo, meaning that exposures were made on two 

separate films using slightly different X-ray tube angles and they were viewed at the same time with a 

stereoscope (Selman 1965, p. 10). The significance of the word “stereo” for dose reconstruction is 

that two exposures were made and, therefore, organ doses should be doubled when dose 

reconstructors find claim file records of stereo projections.

In the complete absence of information about site chest X-ray screening protocol and standard 

projections (including the lack of X-ray records in the claim files), a preemployment, annual, and 

termination PA chest X-ray should be assumed (Wirth 1951, p. 51). This is accomplished through the 

assignment of X-ray dose in the first year of employment followed by an assignment of X-ray dose in 

each subsequent year. If the termination of employment was after the anniversary date (month and 

day) of the beginning of employment, an additional termination X-ray procedure should be assumed 

for that year and the assigned dose should be calculated for two procedures for that year. 

The oblique (OBL) chest projection is usually considered an additional projection because it is used to 

help a physician diagnose suspicious areas on the PA or LAT chest projection. It is not typically 

performed on all workers as part of a screening protocol. However, there is evidence that OBL 

projections increase the diagnostic accuracy of asbestosis and, therefore, could have been included 

as a standard screening projection for asbestos workers (Baker and Greene 1982). OBL chest 

projections are usually performed with the individual’s right or left anterior chest closest to the film, 

and are referred to as the right anterior oblique (RAO) or left anterior oblique (LAO). The X-ray beam 

still enters the individual’s body from the back and exits the front (i.e., PA). If OBL chest projections 

are listed in the worker’s claim file, dose should be included in the dose reconstruction, unless there is 

evidence this projection was done for diagnosis. If only one OBL chest projection was performed, 

dose reconstructors should assume it was the RAO chest. 

The OBL chest projection uses essentially the same technical factors as those for the LAT chest 

projection because the body part thickness is approximately the same for the two projections. When 

organ doses for the OBL projection are not specified in the site profile, they can be assumed to be the 

same as those from the LAT projection except for skin doses. For the LAT chest projection, the beam 

enters on the right side of the body, whereas for the RAO it enters the left side of the body. Tables B4 and B-8 provide guidance for skin dose assignment for RAO and LAO chest projections.

The lordotic chest projection (also known as the Lindblom position) was another additional projection 

requested by physicians to better visualize the apices (i.e., the uppermost portion) of the lungs (Merrill 

1949, p. 13), a common location for TB. The lordotic projection was most commonly performed AP, 

where the individual faced the X-ray tube and leaned backwards from the waist toward the cassette 

for the exposure (Merrill 1949, p. 13). It would not have been performed routinely on all workers as a 

standard screening projection. This is evidenced by the fact that at the Hanford Site, the number of 
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lordotic chest projections is only 2% of the number of PA chest projections in the 10-year period from 

1946 to 1956 (Kirklin 1969). Because active TB was a cause for rejection of a potential worker (i.e., 

not hiring) (Cantril 1951), and the lordotic projection might have been necessary to diagnose active 

TB, the dose from lordotic X-rays in the pre-employment examination should be included in dose 

reconstruction. In the periodic screening examinations of workers after hire, the lordotic projection 

should be included in dose reconstruction unless records provide evidence the exam was performed 

for diagnostic purposes. Organ doses from the lordotic chest projection are not provided after 1985 

because it is unlikely to have been performed after that time with the increasing use of computed 

tomography scans.

The incident air kerma values that were used to determine organ dose equivalents in this TIB are 

listed in Table 4-1. The incident air kerma for a LAT chest X-ray is assumed to be 2.5 times that of a 

PA chest, a conservative value based on measurements from Hanford (Kirklin et al. ca. 1969) where a 

factor of 1.94 was observed and other measurements that suggest the ratio of incident air kerma from 

LAT and PA chest radiographs could have been somewhat greater than that (Stanford and Vance 

1955, p. 7). 

The female lung DCF is higher than that for the male lung for all chest projections except the lordotic. 

The male lung DCF is higher than the female lung DCF for the lordotic chest projection (performed 

AP). Because the higher of the two lung DCFs is used to determine the dose to the other organs in 

the chest cavity (see Section 5.1), the female lung DCF is used to determine the dose to the 

esophagus, stomach, liver/gallbladder/spleen, bone surface, and remainder for all chest projections 

except the lordotic, and the male lung DCF is used to determine the dose to these organs for the 

lordotic projection. 

The hands are considered to within the primary beam during the period of poor collimation (through 

1970) due to the assumption the hands are positioned on the upper, back of the hips during the X-ray 

procedure (GE 1956, pp. 5, 6). 

The organ dose equivalents from all chest projections are in Tables B-10 to B-12 in Attachment B. 

7.2 PHOTOFLUOROGRAPHIC CHEST

Photofluorography (PFG, also known as mass miniature radiography, was used for mass chest 

screenings for TB starting around 1940 (Birkelo et al. 1947). PFG was a mass chest screening 

technique most suitable to large populations because it was time-efficient and cost-effective (ATS

1957, p. 7). Some of the screening chest X-rays with DOE and its predecessor organizations 

occurred with PFG. PFG should not be confused with fluoroscopy, which is discussed in Section 7.3. 

PFG differed from conventional chest radiography on 14- by 17-in. film in that the X-ray image was 

miniaturized with a camera lens or mirror optics system to expose 35-mm film, 70-mm film, 4- by 5-in. 

film, or 4- by 10-in. film for stereo views (two exposures) (Laughlin et al. 1957; Birkelo et al. 1947). 

The worker was positioned in the same PA manner as for a conventional radiographic chest X-ray. 

Most PFG equipment was portable, semiportable, or installed in the limited space of a mobile bus 

(Van Allen 1951, p. 2). Figure 7-1 is a diagram of PFG, and Figure 7-2 is a photograph of a General 

Electric PFG machine.

PFG typically produces higher doses to workers than conventional chest radiography (Braestrup and 

Wyckoff 1958, p. 81; Laughlin et al. 1957; Moeller, Terrill, and Ingraham 1953). Moeller, Terrill, and 

Ingraham (p. 6) stated that the “largest single source of medical radiation exposure in the United 

States is the mass chest X-ray survey for tuberculosis.” The resolution of PFG systems was not as 

good as conventional film screen systems; only 6 line/pairs per mm rather than about 9 or 10

line/pairs per mm (Goodwin, Quimby, and Morgan 1970, p. 108). In addition, the small size of the 
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films made the images difficult to interpret. The higher dose and small film size of PFG, in 

combination with lower resolution and perfection of the Mantoux skin test for TB screening, eventually 

led to PFG becoming obsolete, probably in the mid-1960s. By the mid-1970s, the U.S. Environmental 

Protection Agency recommended, “Whenever possible, Federal agencies should not use 

photofluorographic equipment to perform X-ray examinations” (EPA 1976, p. 19). Unless a site has 

specific evidence to the contrary, the default assumption is that use of PFG ended in 1970. 

Therefore, doses are not assigned after 1970.

Figure 7-1. Essential components of a PFG unit (Selman 1965, p. 19). 

Figure 7-2. Typical General Electric PFG system 

(GE 1963, p. 7). 

Typical reported operating parameters for 1950s PFG were 24 mAs at 83 kVp at a target-to-film 

distance of 36 in. (Braestrup and Wyckoff 1958, p. 81) and 30 mAs at 90 kVp with a target-to-film 
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distance of 40 in. and 2.5 mm added filtration (Laughlin et al. 1957). Phantom measurements in the 

literature indicate an ENSD (including backscatter) of about 0.5 cGy (Laughlin et al. 1957) to 1.53 cGy 

(Rising and Soldat 1959). The incident air kerma value for PFG was derived from the measured skin

dose in Rising and Soldat (1959) and Equation 7-1 below. 

The incident air kerma (Ka,i) corresponding to the published skin dose value is calculated by:

( ) (7-1) a,i 1 cGy/rad ENSD K

BSF =

where

Ka,i = incident air kerma to be used in organ dose calculations (cGy in air) 

ENSD = ENSD (rad) (1.53 for PFG chest; Rising and Soldat 1959)

BSF = backscatter factor (1.35 for 2.5 mm Al HVL; Table B.8, NCRP 1989) 

Because the SID for PFG is shorter than that for conventional radiography, the maximum size of the 

PFG beam is smaller than a poorly collimated beam at 72 in. in conventional chest radiography. For 

dose reconstruction, the PFG beam is assumed to include the thyroid, thoracic organs, small 

intestine, stomach, and liver/gallbladder/spleen, but not the eye/brain, gonads, urinary 

bladder/prostate, or colon/rectum. To ensure that the thyroid dose reflects the assumption that it is in 

the primary beam, the dose to the thyroid was determined using the DCF for the AP cervical spine 

(where the thyroid is definitely in the primary beam) and by correcting for the fact that the PFG chest 

projection was performed PA rather than AP (as is the case for the cervical spine projection). The 

correction consists of multiplying the DCF for the AP cervical spine by a depth dose correction factor 

of 20% (the approximate percentage depth dose at an assumed depth of the thyroid in the neck of 10 

cm) (NCRP 1997; ORAUT 2005). The dose to the eye/brain is determined by using the larger of the 

DCFs for the thyroid for the PA skull or PA chest projections. The DCF for the thyroid dose from the 

PA chest projection is the larger of the two and was used to calculate the dose to the eye/brain for 

PFG.

PFG was commonly performed as a stereo procedure, which required two projections from slightly 

different angles. Therefore, the organ dose equivalents in this TIB assume a stereo exposure. If the 

size of the film in the claim file records is 4- by 10-in., assume stereo projections and assign the organ 

doses in Tables B-10 and B-11 in Attachment B. If the film size in the claim file records is 4- by 5-in., 

assume a single projection and divide the organ doses in Tables B-10 and B-11 in half for dose 

assignment. 

Because PFG was primarily a mass screening technique most suitable to large populations, and 

therefore unlikely to have occurred on a mass scale at AWE sites, PFG should not be assumed to 

have occurred at AWE sites unless there is evidence to the contrary.

The hands are considered to within the primary beam during the period of poor collimation (through 

1970) due to the assumption the hands are positioned on the upper, back of the hips during the X-ray 

procedure (GE 1956, p. 5, 6). Organ dose equivalents from PFG chest X-rays are in Tables B-10 and 

B-11 in Attachment B. 

7.3 CHEST FLUOROSCOPY

Fluoroscopy (not to be confused with PFG above), involves real-time viewing of a fluorescent screen 

continuously activated by X-rays. This procedure was not generally amenable to mass examinations 

or pre-employment screening of workers, and it was not mentioned as a screening technique in a 
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study to determine the most efficacious method for mass screening (Birkelo et al. 1947). In a report 

on chest X-rays, surveys, and radiation exposure, the ATS (1957, p. 7) stated:

Screening of groups by fluoroscopy should be strongly discouraged for several reasons: 

the results are not accurate for diagnostic purposes; there is no permanent film record 

of the examination; and the radiation exposure involved both for the subject and 

examiner is excessive. However, special fluoroscopic examination may be indicated for 

specific diagnostic purposes and for the determination of the dynamics of the chest. 

Although chest fluoroscopy was not a standard pre-employment or occupational screening procedure 

for the chest, there are indications that fluoroscopic chest examinations were conducted and required 

by at least two sites (Linde Ceramics and Battelle King Avenue) and it is possible that such 

examinations were also conducted elsewhere (ORAUT 2015, 2016).

Given the era, the fluoroscopic equipment was most likely to have been “direct” or non-imageintensified fluoroscopy equipment, which is now considered obsolete. While incident air kerma rates 

for this type of equipment can be found in the literature, average fluoroscopy exposure times, 

especially for chest screening examinations, are not commonly found. However, a study of the 

incident air kerma rates, HVLs, and estimated fluoroscopy exposure times was conducted on nonimage-intensified fluoroscopy equipment in the modern era in Albania (Marshall et al. 2001). In this 

study, the exposure time for chest fluoroscopy screening was estimated to be about 20 seconds with 

an average incident air kerma rate of about 4 cGy/min and an average HVL of about 2.3 mm Al. 

Based on the Albania study being in the modern era, additional conservativism in relation to incident 

air kerma rate, time, and HVL was used in this TIB. Chest fluoroscopy dose equivalents in this TIB 

were calculated using an incident air kerma rate of 5 cGy/min for 30 seconds of fluoroscopy time and 

assumed HVL of 2.0 mm Al. For chest fluoroscopy, the SSD is short in comparison to standard chest 

X-ray projection (approximately 40 cm). However, the beam size is estimated to be similar to the 

beam for a poorly collimated radiographic chest X-ray to account for the fact that the field in chest 

fluoroscopy is dynamic and could expose a larger area of the body than the short SSD would initially 

indicate. A diagram of non-image-intensified fluoroscopy is provided in Figure 7-3. The hands are 

considered to within the primary beam during the period of poor collimation (through 1970) due to the 

assumption the hands are positioned on the upper, back of the hips during the X-ray procedure (GE 

1956, pp. 5, 6). Doses for chest fluoroscopy are included in Tables B-10 and B-11 in Attachment B. 
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Figure 7-3. Diagram of non-image-intensified 

fluoroscopy (Massey 1977, p. 90). 

7.4 LUMBAR SPINE

Lumbar spine radiographs have been used since the 1930s to determine the presence of back 

problems or to predict future occurrence of back problems (La Rocca and Macnab 1969, p. 49). At 

some DOE and AWE sites, lumbar spine radiographs were required for certain classes of workers 

(usually men) whose work could entail heavy labor. Typically, if lumbar spine radiography was used 

for screening, it was performed as part of the pre-employment physical examination, and for many 

workers this might have been the only occasion on which lumbar spine radiographs were taken. 

However, the possibility of periodic lumbar spine examinations, including a physical examination at 

the termination of employment, should not be precluded.

The number of lumbar spine projections per examination was likely to have varied from site to site and 

should be documented in the site profile, if they were performed. In a study of the number of lumbar 

spine projections to assess applicants for Veteran’s Administration compensation for lumbar spine 

disease or injury, Eisenberg et al. (1980, p. 4) found that on average the number of lumbar spine 

projections performed at the Administration’s facilities was 4.2 per examination. In the absence of 

evidence to the contrary, a lumbar spine examination for screening should be assumed to consist of 

four projections: AP, LAT, LAT spot of L4-5, and AP spot. The organ dose equivalents for the 

individual projections are provided (see Tables B-13 and B-14). However, if claim file records indicate 

fewer than four projections, dose reconstructors can determine the total dose equivalent accordingly. 

While both the AP and LAT spot projections were likely to have been made on smaller size film and 

with smaller beam sizes, it is assumed for dose reconstruction that these were made on full size 14- 

by 17-in. film.

Eventually, the pre-employment lumbar spine radiographs were shown to have low predictive value 

for future lumbar spine disability (La Rocca and Macnab 1969, p. 53), and various groups 

recommended that lumbar spine radiographs be discontinued for screening (AOMA 1979). Due to 
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this recommendation, unless there is site-specific information to the contrary, the default assumption 

is that lumbar spine exams ended in 1985.

Because of the concern in the 1950s about gonad dose to the population as a whole, there are 

several good studies of measured doses to the skin and gonads from the lumbar spine examinations 

that were conducted then (Lincoln and Gupton 1958; Laughlin et al. 1957; Billings, Norman, and 

Greenfield 1957). Measured skin doses with phantoms (i.e., including backscatter) in these studies 

ranged from 0.25 to 5.2 cGy for the AP lumbar spine projection and from 0.5 to 20.0 cGy for the LAT 

lumbar spine projection depending on the techniques (e.g., kilovoltage, tube current and the amount 

of filtration). The higher skin doses for each of the lumbar spine projections were a result of lowkilovoltage techniques that were conducted in London (Stanford and Vance 1955). Values for the 

same projections using high-voltage techniques were stated to be 1.0 cGy for AP lumbar spine 

projection and 4.8 cGy for the LAT lumbar spine projection (Stanford and Vance 1955). In this TIB, 

the measured skin and gonad doses from Lincoln and Gupton (1958, Table VII) were used because 

the measurements were performed at Oak Ridge National Laboratory (ORNL) Health Center and 

would be more representative of DOE facility equipment and techniques. 

The incident air kerma value for lumbar spine projections through 1970 was derived from the average 

skin doses at ORNL in Lincoln and Gupton (1958, Table VII). The skin dose value for the AP lumbar 

spine is 1,900 mrad, measured with a phantom, and therefore includes backscatter. The incident air 

kerma is derived using Equation 7-1 above. The HVL of 2.0 was determined from the data in Lincoln 

and Gupton (1958, Tables III and IV). Table III shows that for a skin dose of 2,000 mrad, the kVp was 

80 and the filter (assumed to be the added filter) was 1.0 mm Al. Assuming a total filtration of 1.5 mm 

Al eq., the HVL is 1.8, rounded to 2.0 mm Al at 80 kVp from Table B.2 in NCRP Report 102 (NCRP 

1989, p. 56). The incident air kerma for the LAT lumbar spine projection was determined in the same 

way and results in an incident air kerma value of 3.79 cGy. 

The ovary and testes doses for the poor collimation period before 1970 also come directly from 

Lincoln and Gupton (1958, Table VII) because they were measured with a phantom and include 

backscatter. 

X-rays of the lumbar spine were performed AP, often on 14- by 17-in. film in the lengthwise direction, 

and using a 40-in. SID. Figure 7-4 is an approximately scaled diagram of the poorly collimated beam 

(depicted by the green circle) and properly collimated beam (depicted by the blue square) in relation 

to abdominal organs for the AP lumbar spine and helps to visualize the beams. The ovary dose is 

used to determine the dose to the liver/gallbladder/spleen, the urinary bladder/prostate, the 

colon/rectum, bone surfaces, stomach, and remainder organs because these organs are likely to be in 

the primary beam. The breast dose is calculated using the lung DCF as a surrogate since ICRP 34 

does not calculate a DCF for the breast. The DCFs for lumbar spine projections are summarized in 

Table B-3. 

The incident air kerma value for lumbar spine projections after 1970 comes directly from Kereiakes 

and Rosenstein (1980, p. 8). These data are contemporaneous and relevant for use in this period. 
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Figure 7-4. Beam areas in relation to body anatomy for

the AP lumbar spine – green circle indicating poorly 

collimated beam and blue square indicating properly 

collimated beam (modified from Beers 2003, p. 4).

Organ dose equivalents from lumbar spine X-rays are in Tables B-13 and B-14 in Attachment B. 

7.5 PELVIS

In 1932, skeletal fluorosis was discovered as an occupational disease in cryolite (natural fluoride of 

aluminum and sodium) workers in Copenhagen, Denmark (Grandjean 1982). Skeletal fluorosis 

exhibited a variety of radiologic patterns including increased bone density, calcification of ligaments, 

and periosteal changes (Chan-Yeung et al. 1983). During the early years of atomic weapons work, 

the Manhattan Engineer District and the U.S. Atomic Energy Commission sometimes required that 

pelvis X-rays be taken of personnel who worked with materials containing fluoride to detect bone 

changes due to fluorosis (Van Horn 1943; Osinski 1947).

X-rays of the pelvis were used in the 1940s for medical monitoring of workers with potential exposure 

to fluoride and fluoride compounds. It is assumed that by 1960 more specific and sensitive screening 

methods than spine and pelvis radiographs for fluorosis were available. 

Workers in the atomic weapons complex who might have been exposed to fluoride and fluoride 

compounds include workers at the gaseous diffusion plants. In the absence of specific documented 

fluorosis monitoring programs at individual sites, organ doses for pelvis, lumbar, thoracic, and cervical 

spine X-rays should be included in dose reconstructions for workers who were exposed to fluoride 

and fluoride compounds. 

Lincoln and Gupton (1958) measured skin and gonad doses (including backscatter) using a tissueequivalent phantom for various examinations including the AP pelvis. Table V in Lincoln and Gupton 

provides dose information for X-ray examination of the pelvis from some facilities and other literature. 
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Review of this information indicates some facilities using cones and no beam filtration or lack of 

information regarding filtration. In this TIB, the measured skin and gonad doses from Table VII of 

Lincoln and Gupton were used because the measurements were performed at ORNL with techniques 

and filtration that are assumed to be similar to those across DOE facilities. An HVL of 2 mm Al was 

assumed based on the data in Lincoln and Gupton. The incident air kerma was derived using 

Equation 7-1, which resulted in an incident air kerma value for the pelvis of 1.52 cGy.

X-rays of the pelvis were performed AP, often on 14- by 17-in. film placed in the crosswise direction 

and using a 40-in. SID. Figure 7-5 is an approximately scaled diagram of the poorly and properly 

collimated beams in relation to abdominal organs for the AP pelvis and helps to visualize the beam. 

The measured ovary dose was used to determine the dose to the liver/gallbladder/spleen, the urinary 

bladder/prostate, the colon/rectum, stomach, bone surfaces, and remainder organs because these 

organs are likely to be in the primary beam. The breast dose is calculated using the lung DCF as a 

surrogate since ICRP 34 does not calculate a DCF for the breast. 

The DCFs for pelvis projections are summarized in Table B-3. Organ dose equivalents from pelvis 

X-rays are in Tables B-13 and B-14 in Attachment B.

7.6 THORACIC AND CERVICAL SPINE

X-rays of the thoracic spine (also called dorsal spine) or cervical spine were used in the 1940s for 

medical monitoring of workers with potential exposure to fluoride and fluoride compounds similar to 

the X-rays of the pelvis described in Section 7.5. In the absence of specific documented fluorosis 

monitoring programs at individual sites, organ dose equivalents for thoracic and cervical spine X-rays 

should, therefore, be included in dose reconstructions for workers exposed to fluoride and fluoride 

compounds.

Figure 7-5. Beam areas in relation to body anatomy for 

the AP pelvis – green circle indicating poorly collimated 
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beam and blue square indicating properly collimated 

beam (modified from Beers 2003, p. 4). 

Routine protocols for thoracic and cervical spine X-rays are listed in Table 7-1. While it is possible 

that fewer exposures were made for fluorosis monitoring, organ doses for a complete set of 

projections should be assumed unless there is evidence to the contrary in the individual employee’s 

record.

Table 7-1. Typical protocols for thoracic and cervical 

spine examinations through 1970. 

Procedure Projections

Thoracic spine AP, LAT, RPO, LPO, total of four

Cervical spine AP, LAT, RPO, LPO, total of four

a. RPO = right posterior oblique; LPO = left posterior oblique.

The incident air kerma for the thoracic spine was derived from measured skin dose (1.3 and 2.9 rad 

for the AP and LAT/OBL, respectively) in Lincoln and Gupton (1958, Table VII), and Equation 7-1, 

which resulted in an incident air kerma of 0.985 cGy and 2.20 for the AP and LAT/OBL, respectively, 

and an HVL of 2.0 mm Al. It was assumed that all four projections were taken on 14- by 17-in. film 

with a poorly collimated beam. Figure 7-6 illustrates the approximately scaled poorly and wellcollimated beams for the AP thoracic spine.

Figure 7-6. Beam areas in relation to body anatomy 

for the AP thoracic spine – green circle indicating 

poorly collimated beam and blue square indicating 

properly collimated beam (modified from Beers 2003, 

p. 4). 

DCFs were selected from ICRP Publication 34 (ICRP 1982) tables according to the location of the 

organs in relation to the beam. The thyroid is assumed to be in the poorly and properly collimated 

beams while the eye/brain is assumed to not be in the beam. The dose to the eye/brain is usually 
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determined using the thyroid DCF. For thoracic spine procedures, the dose equivalent to the 

eye/brain is assumed to be 10% of the dose equivalent to the thyroid. This estimate is based on the 

finding that scattered radiation produces a dose to the testes equal to 10% of the central beam dose 

when the testes are just outside the beam (Kereiakes and Rosenstein 1980, p. 52). The dose 

equivalents for the ovaries and testes are from measured doses reported in Lincoln and Gupton 

(1958, Table VII). The dose equivalents for the urinary bladder, prostate, colon, and rectum are 

based on the measured ovaries dose. The dose equivalents to the lungs, liver, gallbladder, spleen, 

thymus, esophagus, stomach, bone surfaces and remainder organs are all based on the lung DCF.

The thyroid DCF for the LAT thoracic spine projection does not seem to reflect irradiation by the 

primary beam. Therefore, for the LAT thoracic spine projection, the thyroid dose equivalent was 

based on the DCF for the LAT cervical spine, where the thyroid is definitely in the primary beam. The 

dose equivalent to the eye/brain seems to be approximately 10% of the dose equivalent to the thyroid 

simply by using the thyroid DCF for the LAT thoracic spine and, therefore, that DCF was used.

The right posterior oblique (RPO) and left posterior oblique (LPO) projections of the thoracic spine are 

positioned similarly to the LAT thoracic spine position (i.e., about 20° from the LAT). The organ dose 

equivalents, then, are assumed to be the same for the LAT thoracic spine and the RPO and LPO. 

The skin dose equivalents, however, are different depending on whether the right or left side is closest 

to the beam. Organ dose equivalents for the thoracic spine are in Table B-15, and the skin dose 

equivalents are in Table B-16 in Attachment B.

There is much less data in the literature for the cervical spine. Data on technical factors for cervical 

spine X-rays are from Braestrup and Wyckoff (1958, Tables VI and VII, p. 81). The pertinent data 

from these tables is excerpted in Table 7-2.

Table 7-2. Relevant technical factors for cervical spine projections, HVL = 2.0 mm Al. . 

Projection kVpa mAsa

SID

(cm)a

R/100

(mAs)a,b

SSD

(in.)c

HVL

(mm Al)d

AP cervical spine 58 100 91 0.4 82 2.0

LAT cervical spine 70 150 152e 0.2 153f 2.0

Posterior OBL 

cervical spine

Not applicable Not applicable Not applicable Not applicable 82 2.0

a. Excerpted data from Braestrup and Wyckoff (1958, Tables VI and VII, p. 81).

b. Interpolated for the kVp closest to the kVp listed in the technique factor column, and for the listed SSD.

c. SSD from Table 3-2. 

d. Based on kVp and 2.5 mm Al eq. total filtration in Braestrup and Wyckoff (1958).

e. Longer SID used for the LAT cervical spine to reduce magnification.

f. The SSD for the LAT cervical spine = 183 cm − 15 cm − 5 cm − 10 cm = 153 cm. The additional 10 cm accounts for the 

fact that during the LAT cervical spine the shoulder is against the cassette holder, so the side of the neck is not actually 

in contact with the cassette holder, which affects the SSD calculation.

Incident air kerma values for the AP, LAT, and OBL cervical spine projections were derived from the 

Braestrup and Wyckoff data in Table 4-1 and Equation 7-2: 

(7-2) ( ) ( ) ( )( ) ( )( ) 2

4 1 1

a,i / 100 mAs 2.58 10 C/kg R 33.97J/C 100cGy/Gy 1Gy/1J kg SID K R Actual mAs

SSD

  − − − =   ×  

where

Ka,i = incident air kerma to be used in organ dose calculations (cGy in air)

R/100 mAs = from Table 7-2 

Actual mAs = from Table 7-2 

(SID/SSD)

2

 = inverse square correction for the exposure at SID (91 cm from 

Table 7-2) to the SSD of interest from Table 4-1 
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2.58 × 10-4 C/kg R-1 = conversion factor for converting exposure in R to C/kg

33.97 J/C = the mean energy expended per ion pair formed in air

When positioned for a LAT cervical spine radiograph, the worker’s shoulder is against the cassette 

holder, and the neck is assumed to be another 10 cm away from, and not in contact with, the cassette 

holder, which affects the SSD calculation. Incident air kerma for the posterior OBL cervical spine is 

estimated to be the same as the incident air kerma for the AP projection because the position is 

similar and the tissue thickness of the neck is the same. The HVL is based on the kVp listed in 

Table 7-2 and 2.5 mm Al eq. total filtration from Braestrup and Wyckoff (1958, Table VI). Since the 

OBL cervical spine and AP cervical spine incident air kerma and HVL are the same, the organ doses 

for these projections are also the same. It is assumed that all four projections were taken on 10- by 

12-in. film with a poorly collimated beam. Figure 7-7 illustrates the approximately scaled poorly and 

well-collimated beams for the LAT cervical spine.

The DCF values in ICRP Publication 34 (ICRP 1982) for the cervical spine are based on the 

assumption that the image receptor is 102 cm from the X-ray source and the beam is collimated to an 

image receptor size of 25.4 by 30.5 cm (where 30.5 cm represents the dimension parallel to the 

height of the worker). DCFs for the breast are not computed in Publication 34 for the cervical spine 

procedure. The lung DCF was used instead. The DCFs used for dose reconstruction in this TIB are 

provided in Table B-1.

Figure 7-7. Beam areas in relation to body anatomy for the 

LAT cervical spine – green circle indicating poorly 

collimated beam and blue square indicating properly 

collimated beam (modified from Beers 2003, p. 3).

Again, measured doses for the ovaries and testes were used from Braestrup and Wyckoff (1958). 

The measured dose for the ovary should also be assigned to the urinary bladder, prostate, colon, 

rectum, and uterus. Organ dose equivalents for the cervical spine are in Table B-15, and the skin 

dose equivalents are in Table B-16 in Attachment B. 
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Information from the sites and claim records has not indicated that any thoracic or cervical spine X-ray 

procedures have been required as a condition of employment after 1970. Therefore, X-ray DCFs and 

doses are not provided in this TIB post 1970. If site-specific information becomes available indicating 

that thoracic or cervical spine X-ray procedures have been required as a condition of employment, it 

will be addressed in the site-specific site profile.

7.7 CHRONIC LYMPHOCYTIC LEUKEMIA 

The B-lymphocytes are the tissue at risk for chronic lymphocytic leukemia. The dose equivalent to the 

B-lymphocytes was determined using the method in ORAUT-OTIB-0082, Dose Reconstruction 

Method for Chronic Lymphocytic Leukemia (ORAUT 2012), and International Commission on 

Radiological Protection (ICRP) Publication 34 dose conversion factors (DCFs) (ICRP 1982). The 

dose distributions and corresponding statistical parameters for the dose to the B-lymphocytes for each 

projection and period is listed in Table 7-3.

8.0 UNCERTAINTY ANALYSIS FOR OCCUPATIONAL MEDICAL X-RAY DOSES

Error (deviation from the correct, true, or conventionally accepted value of a quantity) and uncertainty 

(potential range of a stated, measured, assumed, or otherwise determined value of a quantity) provide 

an indication of the confidence of the dose estimates. Error implies knowledge of what the correct or 

actual value is, which is, of course, not known. Therefore, the more appropriate factor is uncertainty, 

which is expressed in terms of a confidence level (e.g., a 99% confidence level indicates that the 

correct or true value, although not actually known, has a 99% probability of falling within the cited 

range). Uncertainty includes both precision (i.e., reproducibility of the measurement) and accuracy 

(i.e., how close the measurement or estimate of dose comes to the actual or correct value).

Table 7-3. Summary table of distribution parameters for CLL. 

Projection Period Distribution Parameter 1 Parameter 2 Parameter 3

Stereo PFG 1942–1965 Weibull 3 2.089366 0.439531 1.09381E–3

PA Chest <1970 Weibull 2 2.919104 0.055807 Not applicable

LAT Chest <1970 Weibull 3 2.708458 0.061275 7.31349E–05

Lordotic Chest <1970 Weibull 2 3.031503 0.064706 Not applicable

PA Chest 1971–1985 Weibull 3 2.053324 0.019034 2.60356E–05

LAT Chest 1971–1985 Weibull 3 2.062635 0.023261 4.39471E–05

Lordotic Chest 1971–1985 Weibull 3 2.019203 0.019588 -2.15618E–06

PA Chest 1986–present Weibull 3 2.121224 0.014800 1.54897E–05

LAT Chest 1986–present Weibull 3 2.121337 0.019882 2.55603E–05

AP LS (or AP spot) <1970 Weibull 3 3.256128 0.204115 -1.06405E–03

AP LS (or AP spot) >1971 Weibull 2 3.220421 0.148508 Not applicable

LAT LS (or LAT spot) <1970 Normal 0.100425 0.031274 Not applicable

LAT LS (or LAT spot) >1971 Normal 0.1112166 0.0346928 Not applicable

In theory, a large number of factors can introduce uncertainties or affect X-ray machine output and 

dose to the worker. However, in practice only five factors can be reasonably considered to have a 

meaningful or significant impact on dose uncertainty. These are:

1. Measurement error, 

2. Variation in kilovoltage (kVp), 

3. Variation in beam current (mA), 

4. Variation in exposure time (s), and

5. Distance from the worker to the source of the X-rays (SSD). 
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The influence of other factors such as use of screens, grids, film speed, and development, while 

potentially variable, do not affect the beam output per se except indirectly because they can influence 

the machine settings (i.e., kVp, mA, and time).

The organ dose equivalents in this TIB are based on incident air kerma values from published 

literature. These actual X-ray beam measurements were made with R-meters or similar ionization 

chamber instruments suitably designed for measurement of photons in the medical X-ray energy 

range. If properly calibrated and used, R-meters and similar instruments typically and historically 

have had an uncertainty of ±2% for photon energies below 400 keV (Kathren and Larson 1969). 

Although more recent versions of these instruments might provide a somewhat smaller uncertainty, 

perhaps on the order of ±1% (NBS 1982; Lamperti, Loftus, and Loevinger 1988), for conservatism the 

uncertainty range of ±2% is applied to measurements of air kerma.

For a given set of machine settings and parameters, X-ray output is theoretically constant. In general, 

for a given kVp setting, variation in kVp falls within ±5% of the machine setting (Rossi 1991, p. 14). 

As noted above, beam intensity is approximately proportional to the 1.7 power of the kilovoltage; this 

translates to an uncertainty of approximately ±8.6% in output beam intensity in the 80- to 100-kVp 

range used in medical radiography. For conservatism, this is rounded up to ±9%.

Similarly, slight variations in tube current are normal; as a tube ages or heats up from use, current can 

change and typically drops. With all other factors constant, beam output reduces in direct proportion 

to the change in tube current. The reduction in beam output from current variation is not more than a 

few percent under normal operating conditions; large decreases are readily detectable and result in 

maintenance on the machine to restore the output or, as a temporary measure, an increase in the 

current or kilovoltage to provide the necessary exposure for proper film density. The estimated 

uncertainty in beam intensity or output attributable to current variation is ±5% (Rossi 1991, p. 18).

Another parameter that has potential to affect dose from a radiographic procedure, perhaps 

significantly, is the time of exposure. A single-phase, full-wave-rectified machine produces 120 pulses 

of X-rays per second. In an exposure time of 1/20 of a second, only six pulses result. A small error in 

the timer that resulted in a change of only ±1 pulse would correspondingly affect the output by ±17%; 

for an exposure time of 1/30 of a second, the change in output corresponding to a deviation of ±1 

pulse is ±25%. Early mechanical timers were inaccurate; accuracy improved significantly with the 

introduction of electronic timers. The assumed uncertainty in beam output attributable to timers is 

±25% (derived by author).

The final factor likely to affect worker dose relates to distance from the source of the X-rays, which is 

an important determinant of the incident air kerma. For a given procedure using a standard SID, the 

SSD is determined largely by the body thickness of the worker and the accuracy of the positioning. 

Information on worker thickness is rarely available, even in the medical literature. Information from 

published literature is provided in Table 8-1. The estimated variation in SSD is no more than a few 

centimeters, with a conservative assumed upper limit of 7.5 cm for typical workers. Using the inverse 

square law, the entrance skin dose is calculated based on the part thickness for PA Chest and LAT 

Chest exams both adding and subtracting 7.5 cm. This results in calculated doses within about 10% 

of the entrance skin dose applied in this document. Therefore, an uncertainty of ±10% is assumed 

due to body thickness variation (derived by author).
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Table 8-1. Adult body thickness from literature (cm). 

Thorax/abdomen

AP thickness

Thorax/abdomen

LAT thickness

Neck

cervical vertebrae

AP thickness

Neck

cervical vertebrae 

LAT thickness Source

Thor. vert. 20–24

Lumb. vert. 18–22

Pelvis 19–23

Chest 20–25

Thor. vert. 28–32

Lumb. vert. 27–32

Chest 27–32

11–14 10–13 Cahoon 1961, 

pp.16–17

23 Not provided 13 Not provided Wochos, Detorie, 

and Cameron 

1979, p. 3

20 34.4 Not provided Not provided Kereiakes and 

Rosenstein 1980, 

p. 34

A reasonable approach is to assume that the uncertainties are in fact random, and therefore to 

compute the combined statistical uncertainty as the square root of the sum of the squares of all the 

uncertainties: (22 + 92

 + 52 + 252 + 102)

1/2 which equals ±28.9%. Rounding this up to ±30% provides 

an adequate and suitably conservative indication of uncertainty. Therefore, for a derived dose 

equivalent to an individual organ, a total combined standard uncertainty of ±30% can be assumed. 

Dose reconstructors should, therefore, input the organ dose equivalent as the mean of a normal 

distribution, with a standard uncertainty of ±30%. 

ENSD measurements were made on nine workers of varying chest thicknesses (builds) at the 

Savannah River Site (Cooley 1967). While Cooley does not report the measured chest thicknesses 

for these nine workers, the ENSDs were reported and reflect the increase in exposure needed to 

radiograph thicker body parts (chests in this case). The measured ENSDs in this small study already 

include the uncertainty in the technical factors (kVp, mA, and time) that were used to make the 

exposures, and can therefore be used a reasonable check of the uncertainty calculated above. The 

standard uncertainty of the range of measurements in Cooley is 5.6, or 21%. This would seem to 

indicate that the 30% assumed uncertainty above is a reasonable estimate to use in dose 

reconstruction of organ dose from medical X-ray procedures.

9.0 X-RAY DOSE ASSIGNMENT BY ICD-10 CODE

Under the EEOICPA, the organs and tissues for which doses must be estimated are those that are 

delineated by the specified ICD-10 code that is received from the U.S. Department of Labor. 

Additional guidance is necessary to identify the appropriate organs or tissues for X-ray dose 

estimation based on the ICD-10 code. 

Attachment A provides guidance by ICD-10 code for the various X-ray views in this TIB. For some 

ICD-10 codes that involve the skin of the body, the specific location of the cancer can influence the 

assignment of X-ray dose. Attachment A refers the dose reconstructor to Attachment B for those 

ICD-10 codes to allow for a more appropriate assignment of dose. For claims in which the specific 

cancer location cannot be determined from the records, the location that results in the X-ray dose 

most favorable to the claimant should be used.

10.0 ATTRIBUTIONS AND ANNOTATIONS

All information requiring identification was addressed via references in the reference section of this 

document.
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REFERENCES

AOMA (American Occupational Medical Association), 1979, “Guidelines for Use of Routine X-Ray 

Examinations in Occupational Medicine,” Statement of the Energy Technology Committee of 

the American Occupational Medical Association, Anaheim, California, April. [SRDB Ref ID: 

93611]

ATS (American Trudeau Society), 1957, The Chest X-Ray and Chest X-Ray Surveys Related to 

X-Ray Radiation Effects and Protection from Radiation Exposure, Report of the Executive 

Committee of the American Trudeau Society, October 15. [SRDB Ref ID: 11325]

Amman, E., 1991, “X-Ray Generator and AEC Design,” Specification, Acceptance Testing and Quality 

Control of Diagnostic X-Ray Imaging Equipment, Medical Physics Monograph No. 20, J. A. 

Seibert, G. T. Barnes, and R. G. Gould, editors, American Association of Physicists in 

Medicine, American Institute of Physics, Melville, New York. [SRDB Ref ID: 168574] 

Antonsen Jr., R. G., 1998, Radiation Protection Survey of the Los Alamos National Laboratory, U.S. 

Department of Health and Human Services, Food and Drug Administration, June. [SRDB Ref 

ID: 82247, p. 12] 

Baker, E. L., and R. Greene, 1982, “Incremental Value of Oblique Chest Radiographs in the Diagnosis 

of Asbestos-Induced Pleural Disease,” American Journal of Industrial Medicine, volume 3, 

pp. 17–22. [SRDB Ref ID: 22751]

Beers, M. H., editor, 2003, The Merck Manual of Medical Information—Second Home Edition, Merck 

& Company, Merck Publishing Group, Rahway, New Jersey. [SRDB Ref ID: 168573] 

Bernacki, R. E., 1994, “Results of Radiological Health Survey,” memorandum to D. Joel (Medical 

Director of Brookhaven National Laboratory), U.S. Food and Drug Administration, Brooklyn, 

New York, July 1. [SRDB Ref ID: 22536, p. 6] 

Billings, M. S., A. Norman, and M. A. Greenfield, 1957, “Gonad Dose during Routine

Roentgenography,” Radiology, volume 69, pp. 37–41. [SRDB Ref ID: 13350]

Birkelo, C. C., W. E. Chamberlain, P. S. Phelps, P. E. Schools, D. Zacks, and J. Yerushalmy, 1947, 

“Tuberculosis Case Finding – A Comparison of the Effectiveness of Various Roentgenographic 

and Photofluorographic Methods,” The Journal of the American Medical Association, volume 

133, number 6, pp. 359–366, February 8. [SRDB Ref ID: 22392]

Bontrager, K. L., and J. P. Lampignano, (2005) Textbook of Radiographic Positioning and Related

Anatomy, Sixth Edition, C. V. Mosby Company, St. Louis, Missouri. [SRDB Ref ID: 176626]

Braestrup, C. B., and H. O. Wyckoff, 1958, Radiation Protection, Charles C. Thomas, Springfield, 

Illinois. [SRDB Ref ID: 32408]

BRH (Bureau of Radiological Health), 1970, Radiological Health Handbook, Revised Edition, U.S. 

Department of Health, Education and Welfare, Rockville, Maryland, January. [SRDB Ref ID: 

75017]

Cahoon, J. B., 1961, Formulating X-Ray Technics, Fifth Edition, Duke University Press, Durham, 

North Carolina. [SRDB Ref ID: 38740]
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 42 of 140

 

Cantril, S. T., 1951, “Industrial Medical Program – Hanford Engineer Works,” in Industrial Medicine on 

the Plutonium Project, National Nuclear Energy Series, Volume 20, Robert S. Stone, M.D., 

editor, McGraw-Hill Book Company, New York, New York. pp. 289–307. [SRDB Ref ID: 739, 

p. 311] 

Chan-Yeung, M., R. Wong, F. Tan, D. Enarson, M. Schulzer, J. Knickerbocker, K. Subbarao, and S. 

Grzybowski, 1983, “Epidemiologic Health Study of Workers in an Aluminum Smelter in Kitimat, 

B.C., II. Effects on Musculoskeletal and Other Systems,” Archives of Environmental Health, 

volume 38, number 1, pp. 34–40. [SRDB Ref ID: 92163]

Cooley, R. C., 1967, “Personnel Radiation Exposures from Medical X-Rays – Savannah River Plant – 

Part II,” memorandum to E. C. Morris, E. I. Du Pont de Nemours and Company, Savannah 

River Plant, Aiken, South Carolina, July 11. [SRDB Ref ID: 68124, p. 123]

Eisenberg, R. L., M. W. Hedgcock, E. A. Williams, B. J. Lyden, J. R. Akin, G. A. W. Gooding, and 

C-O. Ovenfors, 1980, “Optimum Radiographic Examination for Consideration of Compensation 

Awards: II. Cervical and Lumbar Spines,” American Journal of Roentgenology, volume 135, 

pp. 1071–1074. [SRDB Ref ID: 37039]

EPA (U.S. Environmental Protection Agency), 1976, Background Report: Recommendations on 

Guidance for Diagnostic X-Ray Studies in Federal Health Care Facilities, EPA 520/4-76-002, 

Washington, DC. [SRDB Ref ID: 22292]

GE (General Electric Company), 1956, Medical Radiographic Technic, G. W. Files, editor, Charles C.

Thomas, Springfield, Illinois. [SRDB Ref ID: 176625]

GE (General Electric Company), 1963, The Story of X-Ray, publication number 8-3530A, Milwaukee, 

Wisconsin. [SRDB Ref ID: 91664]

Goldman, L. W., and S. Beech, 1979, Analysis of Retakes: Understanding, Managing, and Using an 

Analysis of Retakes Program for Quality Assurance, DHEW Publication (FDA) 79-8097, U.S. 

Department of Health, Education, and Welfare, Public Health Service, Food and Drug 

Administration, Rockville, Maryland, August. [SRDB Ref ID: 38739]

Goodwin, P. N., E. H Quimby, and R. H. Morgan, 1970, Physical Foundations of Radiology, Fourth 

Edition, Harper and Row Publishers, New York, New York. [SRDB Ref ID: 169064] 

Grandjean, P., 1982, “Occupational Fluorosis Through 50 Years: Clinical and Epidemiological 

Experiences,” American Journal of Industrial Medicine, volume 3, number 2, pp. 227–236. 

[SRDB Ref ID: 92612]

Handloser, J. S., and R. A. Love, 1951, “Radiation Doses from Diagnostic X-Ray Studies,” Radiology, 

volume 57, pp. 252–254. [SRDB Ref ID: 13354]

ICRP (International Commission on Radiological Protection), 1982, Protection of the Patient in 

Diagnostic Radiology, Publication 34, Pergamon Press, Oxford, England. [SRDB Ref ID: 

32466] 

ICRP (International Commission on Radiological Protection), 2009, Adult Reference Computational 

Phantoms, Publication 110, Sage Publications, London, England. [SRDB Ref ID: 137018]
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 43 of 140

 

ICRP (International Commission on Radiological Protection), 2010, Conversion Coefficients for 

Radiological Protection Quantities for External Radiation Exposures, Publication 116, Elsevier, 

Amsterdam, Netherlands. [SRDB Ref ID: 111104] 

ICRU (International Commission on Radiation Units and Measurements), 1937, “Recommendations of 

the International Committee for Radiological Units,” Fifth International Congress of Radiology, 

Radiology, volume 29, pp. 634–636. [SRDB Ref ID: 73113] 

ICRU (International Commission on Radiation Units and Measurements), 2005, Patient Dosimetry for 

X-Rays Used in Medical Imaging, Report 74, Oxford University Press, Oxford, England. 

[SRDB Ref ID: 169063] 

Kathren, R. L., and H. V. Larson, 1969, “Radiological Calibration and Standardization for Health 

Physics: A Program, a Plea, and a Proposal,” Health Physics, volume 16, pp. 778–782. 

[SRDB Ref ID: 13356]

Kereiakes, J. G., and M. Rosenstein, 1980, Handbook of Radiation Doses in Nuclear Medicine and 

Diagnostic X-Ray, CRC Press, Boca Raton, Florida, June. [SRDB Ref ID: 11109] 

Kirklin, C. W., 1969, “Annual Medical X-Ray: Individual File, Dosage by Years,” Hanford 

Environmental Health Foundation, Richland, Washington, February 17. [SRDB Ref ID: 

13817]

Kirklin, C. W., B. D. Nuss, K. R. Heid, F. L. Rising, F. E. Adley, and E. B. Lavelle, ca. 1969, The AEC 

Health and Mortality Study: Its Purpose, Scope and Design and the Supporting Data Systems 

from the Hanford Operations: Retrospective and Continuing Phases of Data Acquisition, 

unpublished study, Hanford Environmental Health Foundation, Richland, Washington. [SRDB 

Ref ID: 12330]

La Rocca, H., and Macnab, I., 1969, “Value of Pre-Employment Radiographic Assessment of the 

Lumbar Spine,” Canadian Medical Association Journal, volume 101, pp. 49–54. [SRDB Ref 

ID: 37038]

Lamperti, P. J., T. P. Loftus, and R. Loevinger, 1988, NBS Measurement Services: Calibration of 

X-Ray and Gamma-Ray Measuring Instruments, NBS Special Publication 250-16, National 

Bureau of Standards, National Measurement Laboratory, Center for Radiation Research, 

Gaithersburg, Maryland, March. [SRDB Ref ID: 75020]

Laughlin, J. S., M. L. Meurk, I. Pullman, and R. S. Sherman, 1957, “Bone, Skin, and Gonadal Doses 

in Routine Diagnostic Procedures,” American Journal of Roentgenology, Radium Therapy and 

Nuclear Medicine, volume 78, number 6, pp. 961–982. [SRDB Ref ID: 13071]

Lincoln, T. A., and E. D. Gupton, 1958, “Radiation Doses in Diagnostic X-Ray Procedures,” 

Radiology, volume 71, pp. 208–215. [SRDB Ref ID: 11099]

Marshall, N. W., G. Shehu, D. Marsh, K. Faulkner, J. Malone, and K. Dewhurst, 2001, “Effective Dose 

in Albanian Direct Chest Fluoroscopy,” European Radiology, volume 11, pp. 705–710. [SRDB 

Ref ID: 54301]

Massey, J. B., 1977, “Diagnostic Radiology - I,” Proceedings of the International School of Physics, 

Course LXVI, Health and Medical Physics, J. Baarli, editor, North-Holland Publishing 

Company, New York, New York. [SRDB Ref ID: 169061] 
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 44 of 140

 

Merrill, V., 1949, “Radiography of the Thoracic Viscera,” in Atlas of Roentgenographic Positions, 

Volume II, St. Louis, Missouri. [SRDB Ref ID: 91634]

Moeller, D. W., J. G. Terrill, and S. C. Ingraham, 1953, “Radiation Exposure in the United States,” 

Public Health Reports, volume 68, number 1, pp. 57–65. [SRDB Ref ID: 13355]

NBS (National Bureau of Standards), 1936, X-Ray Protection, Handbook 20, U.S. Department of 

Commerce, Washington, D.C., July 24. [SRDB Ref ID: 73165]

NBS (National Bureau of Standards), 1949, Medical X-Ray Protection up to Two Million Volts, 

Handbook 41, U.S. Department of Commerce, Washington, D.C., March 30. [SRDB Ref ID: 

73169]

NBS (National Bureau of Standards), 1955, X-Ray Protection, Handbook 60, U.S. Department of 

Commerce, Washington, D.C., December 1. [SRDB Ref ID: 73173]

NBS (National Bureau of Standards), 1982, Calibration and Related Measurement Services, Special 

Publication 250, U.S. Department of Commerce, Gaithersburg, Maryland. [SRDB Ref ID: 

168577] 

NCRP (National Council on Radiation Protection and Measurements), 1968, Medical X-Ray and 

Gamma-Ray Protection for Energies Up To 10 MeV, Report 33, Washington, D.C. [SRDB Ref 

ID: 168576] 

NCRP (National Council on Radiation Protection and Measurements), 1976, Structural Shielding 

Design and Evaluation for Medical Use of X Rays and Gamma Rays of Energies up to 10 

MeV, Report 49, Bethesda, Maryland. [SRDB Ref ID: 168575] 

NCRP (National Council on Radiation Protection and Measurements), 1989, Medical X-Ray, Electron 

Beam and Gamma-Ray Protection for Energies up to 50 MeV (Equipment Design, 

Performance and Use), Report 102, Bethesda, Maryland, June 30. [SRDB Ref ID: 32467] 

NIOSH (National Institute for Occupational Safety and Health), 2006, Selection for Internal and 

External Dosimetry Target Organs for Lymphatic/Hematopoietic Cancers, OCAS-TIB-0012, 

Rev. 01, Office of Compensation Analysis and Support, Cincinnati, Ohio, February 10. [SRDB 

Ref ID: 29934]

NIOSH (National Institute for Occupational Safety and Health), 2010, Radiation Exposures Covered 

for Dose Reconstructions under Part B of the Energy Employees Occupational Illness 

Compensation Program Act, DCAS-IG-003, Rev. 01, Division of Compensation Analysis 

and Support, Cincinnati, Ohio, October 5. [SRDB Ref ID: 88929] 

ORAUT (Oak Ridge Associated Universities Team), 2012, Dose Reconstruction Method for Chronic 

Lymphocytic Leukemia, ORAUT-OTIB-0082, Rev. 00 PC-1, Oak Ridge, Tennessee, 

December 20. [SRDB Ref ID: 121337] 

ORAUT (Oak Ridge Associated Universities Team), 2015, An Exposure Matrix for Linde Ceramics 

Plant (Including Tonawanda Laboratory), ORAUT-TKBS-0025, Rev. 04, Oak Ridge, 

Tennessee, May 8. [SRDB Ref ID: 143513] 

ORAUT (Oak Ridge Associated Universities Team), 2016, Site Profile for Battelle Memorial Institute, 

King Avenue and West Jefferson Sites, Columbus, Ohio, ORAUT-TKBS-0058, Rev. 01, Oak 

Ridge, Tennessee, June 27. [SRDB Ref ID: 157122]
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 45 of 140

 

ORAUT (Oak Ridge Associated Universities Team), 2017, Guidance on Assigning Occupational 

X-Ray Dose Under EEOICPA for X-Rays Administered Off Site, ORAUT-OTIB-0079, Rev. 02, 

Oak Ridge, Tennessee, June 15. [SRDB Ref ID: 166967]

ORAUT (Oak Ridge Associated Universities Team), 2019, Internal Dosimetry Organ, External 

Dosimetry Organ, and IREP Model Selection by ICD-10 Code, ORAUT-OTIB-0005, Rev. 06, 

Oak Ridge, Tennessee, September 27. [SRDB Ref ID: 178311] 

Osinski, V., 1947, Ceramics Plant Progress Report for Week Ending December 21, 1947, Linde 

Ceramics Plant, Tonawanda, New York, December 22. [SRDB Ref ID: 8954, pp. 172]

Price, D. E., 1958, “Radiation as a Public Health Problem,” Public Health Reports, volume 73, 

pp. 197–202. [SRDB Ref ID: 34909]

Rising, F. L., and J. K. Soldat, 1959, “Radiation Exposures During Diagnostic Radiographic 

Examinations at Kadlec Methodist Hospital,” memorandum to W. D. Norwood, General Electric 

Company, Richland, Washington, April 30. [SRDB Ref ID: 13343]

Rossi, R. P., 1991, X-Ray Generator and Automatic Exposure Control Device Acceptance Testing, 

Medical Physics Monograph No. 20, Seibert, J. A., G. T. Barnes, and R. G. Gould, editors, 

American Association of Physicists in Medicine, American Institute of Physics, Melville, New 

York. [SRDB Ref ID: 465]

Selman, J., 1965, The Fundamentals of X-ray and Radium Physics, Fourth Edition, Charles C. 

Thomas, Publisher, Springfield, Illinois. [SRDB Ref ID: 14432]

Stanford, R. W., and J. Vance, 1955, “The Quantity of Radiation Received by the Reproductive 

Organs of Patients During Routine Diagnostic X-Ray Examinations,” British Journal of 

Radiology, volume 28, pp. 266–273. [SRDB Ref ID: 55763]

Taylor, L. S., 1957, “Practical Suggestions for Reducing Radiation Exposure in Diagnostic 

Examinations,” American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 

volume 78, number 6, pp. 983–987. [SRDB Ref ID: 13353]

Thomas, M., 1991a, “Results of FDA Diagnostic X-Ray Survey,” memorandum to H. Stauffer (Director 

of Medical Services Department, Lawrence Berkeley Laboratories), U.S. Food and Drug 

Administration, San Francisco, California, September 13. [SRDB Ref ID: 23503]

Thomas, M., 1991b, “Results of FDA Diagnostic X-Ray Survey,” memorandum to J. H. Spickard 

(Health Sciences Department, Lawrence Livermore National Laboratory), U.S. Food and Drug 

Administration, San Francisco, California. [SRDB Ref ID: 13881]

Trout, E. D., G. Jacobson, R. T. Moore, and E. P. Shoub, 1973, “Analysis of the Rejection Rate of 

Chest Radiographs Obtained During the Coal Mine ‘Black Lung’ Program,” Radiology, volume 

109, pp. 25–27. [SRDB Ref ID: 11321]

Trout, E. D., J. P. Kelley, and G. A. Cathey, 1952, “The Use of Filters to Control Radiation Exposure 

to the Patient in Diagnostic Roentgenology,” American Journal of Roentgenology, Radium 

Therapy, and Nuclear Medicine, volume 67, number 6, pp. 946–963. [SRDB Ref ID: 13358]

Van Allen, W. W., 1951, “Secondary Radiation Fields Surrounding Photofluorographic Equipment,” 

Radiology, volume 56, number 6, pp. 832–841. [SRDB Ref ID: 34906]
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 46 of 140

 

Van Horn, E. L., 1943, letter to T. J. Coleman (Linde Air Products Company), U.S. Army Corps of 

Engineers, September 4. [SRDB Ref ID: 8908, p. 5]

Wall, B. F., R. M. Harrison, and F. W. Spiers, 1988, Patient Dosimetry Techniques in Diagnostic 

Radiology, Report No. 53, The Institute of Physical Sciences in Medicine, York, England. 

[SRDB Ref ID: 169062] 

Webster, E. W., and O. E. Merrill, 1957, “Radiation Hazards, II. Measurements of Gonadal Dose in 

Radiographic Examinations,” New England Journal of Medicine, volume 257, number 17, 

pp. 811–819. [SRDB Ref ID: 11100]

Wirth, J. E., 1951, “Medical Services of the Plutonium Project,” in Industrial Medicine on the Plutonium 

Project, National Nuclear Energy Series, Manhattan Project Technical Section, Division IV, 

Vol. 20, R. S. Stone, M.D., editor, McGraw-Hill Book Company, Inc., New York, pp. 19-35. 

[SRDB Ref ID: 739, p. 42] 

Wochos, J. F., N. A. Detorie, and J. R. Cameron, 1979, “Patient Exposure from Diagnostic X-Rays: 

An Analysis of 1972-1975 NEXT Data,” Health Physics, volume 36, number 2, pp. 127–134. 

[SRDB Ref ID: 91506]

WSDH (Washington State Department of Health), 2001, collection of Hanford X-Ray Registration 

Applications, Olympia, Washington. [SRDB Ref ID: 4901].
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ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES

LIST OF TABLES

TABLE TITLE PAGE

A-1 Selection of organs for X-ray dose assignment during dose reconstruction based on 

ICD-10 code...........................................................................................................................48

A-2 Selection of organs for chest X-ray dose assignment through 1970 based on ICD-10 

code when referred from Table A-1 ........................................................................................ 87

A-3 Selection of organs for chest X-ray dose assignment after 1970 based on ICD-10 code 

when referred from Table A-1 ................................................................................................ 96

A-4 Selection of organs for lumbar spine X-ray dose assignment based on ICD-10 code 

when referred from Table A-1 .............................................................................................. 104

A-5 Selection of organs for thoracic spine X-ray dose assignment based on ICD-10 code 

when referred from Table A-1 .............................................................................................. 105

A-6 Selection of organs for cervical spine X-ray dose reconstruction based on ICD-10 code 

when different organ selection is required based on view..................................................... 107
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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Table A-1. Selection of organs for X-ray dose assignment during dose reconstruction based on ICD-10 code.

ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C00 Malignant neoplasm of lip See Tables A-2 and 

A-3

Eye/brain See Table A-5 ENSD Eye/brain

C01 Malignant neoplasm of base of tongue Thyroid Thyroid Thyroid Thyroid Thyroid

C02.0 Malignant neoplasm of dorsal surface of tongue Thyroid Thyroid Thyroid Thyroid Thyroid

C02.1 Malignant neoplasm of border of tongue Thyroid Thyroid Thyroid Thyroid Thyroid

C02.2 Malignant neoplasm of ventral surface of tongue Thyroid Thyroid Thyroid Thyroid Thyroid

C02.3 Malignant neoplasm of anterior two-thirds of 

tongue, part unspecified

Thyroid Thyroid Thyroid Thyroid Thyroid

C02.4 Malignant neoplasm of lingual tonsil Esophagus Esophagus Esophagus Esophagus Esophagus

C02.8 Malignant neoplasm of overlapping sites of 

tongue

Thyroid Thyroid Thyroid Thyroid Thyroid

C02.9 Malignant neoplasm of tongue, unspecified Thyroid Thyroid Thyroid Thyroid Thyroid

C03 Malignant neoplasm of gum Thyroid Thyroid Thyroid Thyroid Thyroid

C04 Malignant neoplasm of floor of mouth Thyroid Thyroid Thyroid Thyroid Thyroid

C05 Malignant neoplasm of palate/uvula Thyroid Thyroid Thyroid Thyroid Thyroid

C06 Malignant neoplasm of mouth Thyroid Thyroid Thyroid Thyroid Thyroid

C07 Malignant neoplasm of parotid gland Thyroid Thyroid Thyroid Thyroid Thyroid

C08 Malignant neoplasm of salivary gland Thyroid Thyroid Thyroid Thyroid Thyroid

C09 Malignant neoplasm of tonsil Esophagus Esophagus Esophagus Esophagus Esophagus

C10 Malignant neoplasm of oropharynx Thyroid Thyroid Thyroid Thyroid Thyroid

C11 Malignant neoplasm of nasopharynx Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C12 Malignant neoplasm of pyriform sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C13 Malignant neoplasm of hypopharynx Thyroid Thyroid Thyroid Thyroid Thyroid

C14 Malignant neoplasm of pharynx/oral cavity Thyroid Thyroid Thyroid Thyroid Thyroid

C15.3 Malignant neoplasm of upper third of esophagus Esophagus Esophagus Esophagus Esophagus Esophagus

C15.4 Malignant neoplasm of middle third of esophagus Esophagus Esophagus Esophagus Esophagus Esophagus

C15.5 Malignant neoplasm of lower third of esophagus Stomach Stomach Stomach Stomach Stomach

C15.8 Malignant neoplasm of overlapping sites of 

esophagus

Stomach Stomach Stomach Stomach Stomach

C15.9 Malignant neoplasm of esophagus, unspecified Stomach Stomach Stomach Stomach Stomach

C16 Malignant neoplasm of stomach Stomach Stomach Stomach Stomach Stomach

C17.0 Malignant neoplasm of duodenum Stomach Stomach Stomach Stomach Ovaries

C17.1 Malignant neoplasm of jejunum Stomach Stomach Stomach Stomach Stomach

C17.2 Malignant neoplasm of ileum Colon Colon Colon Colon Colon

C17.3 Meckel's diverticulum, malignant Colon Colon Colon Colon Colon
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C17.8 Malignant neoplasm of overlapping sites of small 

intestine

Stomach Stomach Stomach Stomach Stomach

C17.9 Malignant neoplasm of small intestine, 

unspecified

Stomach Stomach Stomach Stomach Stomach

C18.0 Malignant neoplasm of cecum Colon Colon Colon Colon Colon

C18.1 Malignant neoplasm of appendix Colon Colon Colon Colon Colon

C18.2 Malignant neoplasm of ascending colon Stomach Stomach Stomach Stomach Stomach

C18.3 Malignant neoplasm of hepatic flexure Stomach Stomach Stomach Stomach Stomach

C18.4 Malignant neoplasm of transverse colon Stomach Stomach Stomach Stomach Stomach

C18.5 Malignant neoplasm of splenic flexure Stomach Stomach Stomach Stomach Stomach

C18.6 Malignant neoplasm of descending colon Stomach Stomach Stomach Stomach Stomach

C18.7 Malignant neoplasm of sigmoid colon Stomach Stomach Stomach Stomach Stomach

C18.8 Malignant neoplasm of overlapping sites of colon Stomach Stomach Stomach Stomach Stomach

C18.9 Malignant neoplasm of colon, unspecified Stomach Stomach Stomach Stomach Stomach

C19 Malignant neoplasm of rectosigmoid junction Colon Colon Colon Colon Colon

C20 Malignant neoplasm of rectum Colon Colon Colon Colon Colon

C21 Malignant neoplasm of rectum, anus, and anal 

cavity

Colon Colon Colon Colon Colon

C22 Liver carcinoma Liver Liver Liver Liver Liver

C23 Malignant neoplasm of gallbladder Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

C24 Malignant neoplasm of biliary tract Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

C25 Malignant neoplasm of pancreas Liver Liver Liver Liver Liver

C26.0 Malignant neoplasm of intestinal tract, part 

unspecified

Stomach Stomach Stomach Stomach Stomach

C26.1 Malignant neoplasm of spleen Liver Liver Liver Liver Liver

C26.9 Malignant neoplasm of ill-defined sites within the 

digestive system

Stomach Stomach Stomach Stomach Stomach

C30 Malignant neoplasm of nasal cavity/middle ear Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C31 Malignant neoplasm of sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C32 Malignant neoplasm of larynx Thyroid Thyroid Thyroid Thyroid Thyroid

C33 Malignant neoplasm of trachea Lung Lung Lung Lung Lung

C34 Malignant neoplasm of bronchus/lung Lung Lung Lung Lung Lung

C37 Malignant neoplasm of thymus Thymus Thymus Thymus Thymus Thymus

C38 Malignant neoplasm of heart Lung Lung Lung Lung Lung

C39 Malignant neoplasm of upper/lower respiratory 

tract, part unspecified

Lung Lung Lung Lung Lung
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C40.0 Malignant neoplasm of scapula and long bones 

of upper limb

ENSD 10% ENSD ENSD See Table A-6 10% ENSD

C40.1 Malignant neoplasm of short bones of upper limb ENSD see Table A-4 ENSD RSD (0.40 m) 10% ENSD

C40.2 Malignant neoplasm of long bones of unspecified 

lower limb

RSD (0.52 m) 10% ENSD RSD (0.52 m) RSD (0.40 m) 10% ENSD

C40.3 Malignant neoplasm of short bones of lower limb RSD (0.86 m) RSD (0.60 m) RSD (0.86 m) RSD (1.00 m) RSD (0.60 m)

C40.8 Malignant neoplasm of overlapping sites of bone 

and articular cartilage of limb

ENSD see Table A-4 ENSD See Table A-6 10% ENSD

C40.9 Malignant neoplasm of unspecified bones and 

articular cartilage of limb

ENSD see Table A-4 ENSD See Table A-6 10% ENSD

C41.0 Malignant neoplasm of bones of skull and face See Tables A-2 and 

A-3

Eye/brain See Table A-5 ENSD Eye/brain

C41.1 Malignant neoplasm of mandible Thyroid Thyroid Thyroid Thyroid Thyroid

C41.2 Malignant neoplasm of vertebral column Bone surface Bone surface Bone surface Bone surface Bone surface

C41.3 Malignant neoplasm of ribs, sternum and clavicle Bone surface Lung Bone surface Bone surface Lung

C41.4 Malignant neoplasm of pelvic bones, sacrum and 

coccyx

Colon Bone surface Bone surface Bone surface Bone surface

C41.9 Malignant neoplasm of bone and articular 

cartilage, unspecified

Bone surface Bone surface Bone surface Bone surface Bone surface

C43.0 Malignant melanoma of lip See Tables A-2 and 

A-3

Eye/brain See Table A-5 ENSD Eye/brain

C43.1 Malignant melanoma of eyelid, including canthus See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.2 Malignant melanoma of ear and external 

auricular canal

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.3 Malignant melanoma of face See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.4 Malignant melanoma of scalp and neck See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.51 Malignant melanoma of anal skin See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.52 Malignant melanoma of skin of breast See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.59 Malignant melanoma of other part of trunk See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C43.60 Malignant melanoma of unspecified upper limb, 

including shoulder

ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

C43.61 Malignant melanoma of right upper limb, 

including shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.62 Malignant melanoma of left upper limb, including 

shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.70 Malignant melanoma of unspecified lower limb, 

including hip

See Tables A-2 and 

A-3

ENSD 10% ENSD RSD (0.50 m) ENSD

C43.71 Malignant melanoma of right lower limb, 

including hip

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.72 Malignant melanoma of left lower limb, including 

hip

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.8 Malignant melanoma of overlapping sites of skin See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C43.9 Malignant melanoma of skin, unspecified See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.0 Unspecified malignant neoplasm of lip See Tables A-2 and 

A-3

Eye/brain See Table A-5 ENSD Eye/brain

C44.1 Unspecified malignant neoplasm of skin of 

eyelid, including canthus

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.2 Unspecified malignant neoplasm of skin of ear 

and external auricular canal

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.3 Unspecified malignant neoplasm of skin of face See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.4 Malignant neoplasm/BCC/SCC of skin of scalp 

and neck

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.5 Malignant neoplasm/BCC/SCC of trunk See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.6 Malignant neoplasm/BCC/SCC of skin of upper 

limb, including shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.7 Malignant neoplasm/BCC/SCC of skin of lower 

limb, including hip

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.8 Malignant neoplasm of overlapping sites of skin ENSD ENSD ENSD ENSD ENSD

C44.9 Malignant neoplasm/BCC/SCC of skin, 

unspecified

ENSD ENSD ENSD ENSD ENSD

C45.0 Mesothelioma of pleura Lung Lung Lung Lung Lung
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C45.1 Mesothelioma of peritoneum Stomach Stomach Stomach Stomach Stomach

C45.2 Mesothelioma of pericardium Lung Lung Lung Lung Lung

C45.7 Mesothelioma of other sites Remainder Remainder Remainder Remainder Remainder

C45.9 Mesothelioma, unspecified Remainder Remainder Remainder Remainder Remainder

C46.0 Kaposi's sarcoma of skin ENSD ENSD ENSD ENSD ENSD

C46.1 Kaposi's sarcoma of soft tissue Remainder Remainder Remainder Remainder Remainder

C46.2 Kaposi's sarcoma of palate Thyroid Thyroid Thyroid Thyroid Thyroid

C46.3 Kaposi's sarcoma of lymph nodes Remainder Remainder Remainder Remainder Remainder

C46.4 Kaposi's sarcoma of gastrointestinal sites Stomach Stomach Stomach Stomach Stomach

C46.50 Kaposi's sarcoma of unspecified lung Lung Lung Lung Lung Lung

C46.51 Kaposi's sarcoma of right lung Lung Lung Lung Lung Lung

C46.52 Kaposi's sarcoma of left lung Lung Lung Lung Lung Lung

C46.7 Kaposi's sarcoma of other sites Remainder Remainder Remainder Remainder Remainder

C46.9 Kaposi's sarcoma, unspecified Remainder Remainder Remainder Remainder Remainder

C47.0 Malignant neoplasm of peripheral nerves of 

head, face and neck

See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

C47.1 Malignant neoplasm of peripheral nerves of 

upper limb, including shoulder

ENSD 10% ENSD ENSD See Table A-6 10% ENSD

C47.2 Malignant neoplasm of peripheral nerves of lower 

limb, including hip

10% ENSD See Tables B5 and B-910% ENSD RSD (0.50 m) ENSD

C47.3 Malignant neoplasm of peripheral nerves of 

thorax

Remainder Remainder See Table A-5 See Table A-6 Lung

C47.4 Malignant neoplasm of peripheral nerves of 

abdomen

Remainder Remainder See Table A-5 Remainder ENSD

C47.5 Malignant neoplasm of peripheral nerves of 

pelvis

Colon Colon Colon Colon ENSD

C47.6 Malignant neoplasm of peripheral nerves of 

trunk, unspecified

Remainder Remainder See Table A-5 See Table A-6 ENSD

C47.8 Malignant neoplasm of overlapping sites of 

peripheral nerves and autonomic nervous system

Remainder Remainder See Table A-5 See Table A-6 ENSD

C47.9 Malignant neoplasm of peripheral nerves and 

autonomic nervous system, unspecified

Remainder Remainder See Table A-5 See Table A-6 ENSD

C48 Malignant neoplasm of retroperitoneum and 

peritoneum

Stomach Stomach Stomach Stomach Stomach

C49.0 Malignant neoplasm of connective and soft tissue 

of head, face and neck

See Tables A-2 and 

A-3

Eye/brain See Table A-5 ENSD Eye/brain
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C49.1 Malignant neoplasm of connective and soft tissue 

of upper limb, including shoulder

ENSD 10% ENSD ENSD See Table A-6 10% ENSD

C49.2 Malignant neoplasm of connective and soft tissue 

of lower limb, including hip

10% ENSD See Tables B5 and B-910% ENSD RSD (0.50 m) ENSD

C49.3 Malignant neoplasm of connective and soft tissue 

of thorax

Remainder Remainder See Table A-5 See Table A-6 Lung

C49.4 Malignant neoplasm of connective and soft tissue 

of abdomen

Remainder Remainder See Table A-5 Remainder ENSD

C49.5 Malignant neoplasm of connective and soft tissue 

of pelvis

Colon Colon Colon Colon ENSD

C49.6 Malignant neoplasm of connective and soft tissue 

of trunk, unspecified

Remainder Remainder See Table A-5 See Table A-6 ENSD

C49.8 Malignant neoplasm of overlapping sites of 

connective and soft tissue

Remainder Remainder See Table A-5 See Table A-6 ENSD

C49.9 Malignant neoplasm of connective and soft 

tissue, unspecified

Remainder Remainder See Table A-5 See Table A-6 ENSD

C49.A Gastrointestinal stromal tumor Stomach Stomach Stomach Stomach Stomach

C44.39 Other specified malignant neoplasm of skin of 

parts of face

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.4 Malignant neoplasm/BCC/SCC of skin of scalp 

and neck

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.5 Malignant neoplasm/BCC/SCC of anal skin, 

breast, trunk

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.6 Malignant neoplasm/BCC/SCC of skin of upper 

limb, including shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.7 Malignant neoplasm/BCC/SCC of skin of 

unspecified lower limb, including hip

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C44.8 Malignant neoplasm/BCC/SCC of overlapping 

sites of skin

ENSD ENSD ENSD ENSD ENSD

C44.9 Malignant neoplasm/BCC/SCC of skin, 

unspecified

ENSD ENSD ENSD ENSD ENSD

C45.0 Mesothelioma of pleura Lung Lung Lung Lung Lung

C45.1 Mesothelioma of peritoneum Stomach Stomach Stomach Stomach Stomach

C45.2 Mesothelioma of pericardium Lung Lung Lung Lung Lung

C45.7 Mesothelioma of other sites Remainder Remainder Remainder Remainder Remainder

C45.9 Mesothelioma, unspecified Remainder Remainder Remainder Remainder Remainder
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C46.0 Kaposi's sarcoma of skin ENSD ENSD ENSD ENSD ENSD

C46.1 Kaposi's sarcoma of soft tissue Remainder Remainder Remainder Remainder Remainder

C46.2 Kaposi's sarcoma of palate Thyroid Thyroid Thyroid Thyroid Thyroid

C46.3 Kaposi's sarcoma of lymph nodes Remainder Remainder Remainder Remainder Remainder

C46.4 Kaposi's sarcoma of gastrointestinal sites Stomach Stomach Stomach Stomach Stomach

C46.50 Kaposi's sarcoma of unspecified lung Lung Lung Lung Lung Lung

C46.51 Kaposi's sarcoma of right lung Lung Lung Lung Lung Lung

C46.52 Kaposi's sarcoma of left lung Lung Lung Lung Lung Lung

C46.7 Kaposi's sarcoma of other sites Remainder Remainder Remainder Remainder Remainder

C46.9 Kaposi's sarcoma, unspecified Remainder Remainder Remainder Remainder Remainder

C47.0 Malignant neoplasm of peripheral nerves of 

head, face and neck

See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

C47.1 Malignant neoplasm of peripheral nerves of 

upper limb, including shoulder

ENSD 10% ENSD ENSD See Table A-6 10% ENSD

C47.2 Malignant neoplasm of peripheral nerves of lower 

limb, including hip

10% ENSD See Tables B5 and B-910% ENSD RSD (0.50 m) ENSD

C47.3 Malignant neoplasm of peripheral nerves of 

thorax

Remainder Remainder See Table A5See Table A-6 Lung

C47.4 Malignant neoplasm of peripheral nerves of 

abdomen

Remainder Remainder See Table A5Remainder ENSD

C47.5 Malignant neoplasm of peripheral nerves of 

pelvis

Colon Colon Colon Colon ENSD

C47.6 Malignant neoplasm of peripheral nerves of 

trunk, unspecified

Remainder Remainder See Table A5See Table A-6 ENSD

C47.8 Malignant neoplasm of overlapping sites of 

peripheral nerves and autonomic nervous system

Remainder Remainder See Table A5See Table A-6 ENSD

C47.9 Malignant neoplasm of peripheral nerves and 

autonomic nervous system, unspecified

Remainder Remainder See Table A5See Table A-6 ENSD

C48. Malignant neoplasm of retroperitoneum and 

peritoneum

Stomach Stomach Stomach Stomach Stomach

C49.0 Malignant neoplasm of connective and soft tissue 

of head, face and neck

See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

C49.1 Malignant neoplasm of connective and soft tissue 

of upper limb, including shoulder

ENSD 10% ENSD ENSD See Table A-6 10% ENSD

C49.2 Malignant neoplasm of connective and soft tissue 

of lower limb, including hip

10% ENSD See Tables B5 and B-910% ENSD RSD (0.50 m) ENSD
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C49.3 Malignant neoplasm of connective and soft tissue 

of thorax

Remainder Remainder See Table A5See Table A-6 Lung

C49.4 Malignant neoplasm of connective and soft tissue 

of abdomen

Remainder Remainder See Table A5Remainder ENSD

C49.5 Malignant neoplasm of connective and soft tissue 

of pelvis

Colon Colon Colon Colon ENSD

C49.6 Malignant neoplasm of connective and soft tissue 

of trunk, unspecified

Remainder Remainder See Table A5See Table A-6 ENSD

C49.8 Malignant neoplasm of overlapping sites of 

connective and soft tissue

Remainder Remainder See Table A5See Table A-6 ENSD

C49.9 Malignant neoplasm of connective and soft 

tissue, unspecified

Remainder Remainder See Table A5See Table A-6 ENSD

C49.A0 Gastrointestinal stromal tumor, unspecified site Stomach Stomach Stomach Stomach Stomach

C49.A1 Gastrointestinal stromal tumor of esophagus Stomach Stomach Stomach Stomach Stomach

C49.A2 Gastrointestinal stromal tumor of stomach Stomach Stomach Stomach Stomach Stomach

C49.A3 Gastrointestinal stromal tumor of small intestine Stomach Stomach Stomach Stomach Stomach

C49.A4 Gastrointestinal stromal tumor of large intestine Stomach Stomach Stomach Stomach Stomach

C49.A5 Gastrointestinal stromal tumor of rectum Colon Colon Colon Colon Colon

C49.A9 Gastrointestinal stromal tumor of other sites Stomach Stomach Stomach Stomach Stomach

C4A.0 Merkel cell carcinoma of lip See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

C4A.1 Merkel cell carcinoma of eyelid, including 

canthus

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.2 Merkel cell carcinoma of ear and external 

auricular canal

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.3 Merkel cell carcinoma of face See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.4 Merkel cell carcinoma of scalp and neck See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.5 Merkel cell carcinoma of anal skin, breast, trunk See Tables B-4 and

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.6 Merkel cell carcinoma of upper limb, including 

shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.7 Merkel cell carcinoma of lower limb, including hip See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C4A.8 Merkel cell carcinoma of overlapping sites See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C4A.9 Merkel cell carcinoma, unspecified See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C50 Malignant neoplasm of nipple and areola, breast Breast Breast Breast Breast Breast

C51 Malignant neoplasm of labium, clitoris, vulva Uterus Uterus Uterus Uterus Uterus

C52 Malignant neoplasm of vagina Uterus Uterus Uterus Uterus Uterus

C53 Malignant neoplasm of cervix Uterus Uterus Uterus Uterus Uterus

C54 Malignant neoplasm of corpus uteri Uterus Uterus Uterus Uterus Uterus

C55 Malignant neoplasm of uterus, part unspecified Uterus Uterus Uterus Uterus Uterus

C56 Malignant neoplasm of ovary Ovaries Ovaries Ovaries Ovaries Ovaries

C57 Malignant neoplasm of fallopian tube, ligament, 

female genital organs

Ovaries Ovaries Ovaries Ovaries Ovaries

C58 Malignant neoplasm of placenta Uterus Uterus Uterus Uterus Uterus

C60.0 Malignant neoplasm of prepuce, penis Testes Testes Testes Testes Testes

C61 Malignant neoplasm of prostate Bladder Bladder Bladder Bladder Bladder

C62 Malignant neoplasm of undescended testis Testes Testes Testes Testes Testes

C63 Malignant neoplasm of epididymis, male genital 

organ

Testes Testes Testes Testes Testes

C64 Malignant neoplasm of kidney, except renal 

pelvis

Liver Liver Liver Liver Liver

C65 Malignant neoplasm of renal pelvis Liver Liver Liver Liver Liver

C66 Malignant neoplasm of ureter Bladder Bladder Bladder Bladder Bladder

C67 Malignant neoplasm of bladder Bladder Bladder Bladder Bladder Bladder

C68.0 Malignant neoplasm of urethra Bladder Bladder Bladder Bladder Bladder

C68.1 Malignant neoplasm of paraurethral glands Bladder Bladder Bladder Bladder Bladder

C68.8 Malignant neoplasm of overlapping sites of 

urinary organs

Liver Liver Liver Liver Liver

C68.9 Malignant neoplasm of urinary organ, unspecified Liver Liver Liver Liver Liver

C69 Malignant neoplasm of eye Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C70.0 Malignant neoplasm of cerebral meninges Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C70.1 Malignant neoplasm of spinal meninges Remainder Remainder Remainder Eye/brain Remainder

C70.9 Malignant neoplasm of meninges, unspecified Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C71 Malignant neoplasm of brain Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C72.0 Malignant neoplasm of spinal cord Remainder Remainder Remainder Eye/brain Remainder

C72.1 Malignant neoplasm of cauda equina Remainder Remainder Remainder Remainder Remainder
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C72.2 Malignant neoplasm of olfactory nerve Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C72.3 Malignant neoplasm of optic nerve Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C72.4 Malignant neoplasm of acoustic nerve Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C72.5 Malignant neoplasm of cranial nerves Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C72.9 Malignant neoplasm of central nervous system, 

unspecified

Remainder Remainder Remainder Eye/brain Remainder

C73 Malignant neoplasm of thyroid gland Thyroid Thyroid Thyroid Thyroid Thyroid

C74 Malignant neoplasm of cortex of adrenal gland Remainder Remainder Remainder Remainder Remainder

C75.0 Malignant neoplasm of parathyroid gland Thyroid Thyroid Thyroid Thyroid Thyroid

C75.1 Malignant neoplasm of pituitary gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C75.2 Malignant neoplasm of craniopharyngeal duct Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C75.3 Malignant neoplasm of pineal gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C75.4 Malignant neoplasm of carotid body Thyroid Thyroid Thyroid Thyroid Thyroid

C75.5 Malignant neoplasm of aortic body and other 

paraganglia

Remainder Remainder Remainder Eye/brain Remainder

C75.8 Malignant neoplasm with pluriglandular 

involvement, unspecified

Remainder Remainder Remainder Eye/brain Remainder

C75.9 Malignant neoplasm of endocrine gland, 

unspecified

Remainder Remainder Remainder Eye/brain Remainder

C76.0 Malignant neoplasm of head, face and neck Thyroid Thyroid Thyroid Thyroid Thyroid

C76.1 Malignant neoplasm of thorax Remainder Remainder Remainder Remainder Remainder

C76.2 Malignant neoplasm of abdomen Remainder Remainder Remainder Remainder ENSD

C76.3 Malignant neoplasm of pelvis Remainder Remainder Remainder Remainder ENSD

C76.40 Malignant neoplasm of unspecified upper limb ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

C76.41 Malignant neoplasm of right upper limb See Tables B-4 and 

B-8

See Tables B5 and B-9ENSD See Table B-7 10% ENSD

C76.42 Malignant neoplasm of left upper limb See Tables B-4 and 

B-8

See Tables B5 and B-9ENSD See Table B-7 10% ENSD

C76.50 Malignant neoplasm of unspecified lower limb RSD (0.52 m) 10% ENSD RSD (0.52 m) RSD (0.70 m) 10% ENSD

C76.51 Malignant neoplasm of right lower limb RSD (0.52 m) 10% ENSD RSD (0.52 m) RSD (0.70 m) 10% ENSD

C76.52 Malignant neoplasm of left lower limb RSD (0.52 m) 10% ENSD RSD (0.52 m) RSD (0.70 m) 10% ENSD

C76.8 Malignant neoplasm of other specified ill-defined 

sites

Remainder Remainder Remainder Remainder Remainder

C77 Secondary Cancer – Lymph nodes of head, face 

and neck

Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C78.0 Secondary Cancer – Lung, respiratory, lymph, 

digestive

Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea

C7B Secondary Cancer – Lymph nodes, liver, bone, 

peritoneum, Merkel cell

Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea

C79 Secondary Cancer – Urinary organs, skin, brain, 

bone, ovary

Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea

C7A.00 Malignant carcinoid tumor of unspecified site Remainder Remainder Remainder Remainder Remainder

C7A.010 Malignant carcinoid tumor of the duodenum Stomach Stomach Stomach Stomach Stomach

C7A.011 Malignant carcinoid tumor of the jejunum Stomach Stomach Stomach Stomach Stomach

C7A.012 Malignant carcinoid tumor of the ileum Colon Colon Colon Colon Colon

C7A.019 Malignant carcinoid tumor of the small intestine, 

unspecified portion

Stomach Stomach Stomach Stomach Stomach

C7A.020 Malignant carcinoid tumor of the appendix Colon Colon Colon Colon Colon

C7A.021 Malignant carcinoid tumor of the cecum Colon Colon Colon Colon Colon

C7A.022 Malignant carcinoid tumor of the ascending colon Stomach Stomach Stomach Stomach Stomach

C7A.023 Malignant carcinoid tumor of the transverse colon Stomach Stomach Stomach Stomach Stomach

C7A.024 Malignant carcinoid tumor of the descending 

colon

Stomach Stomach Stomach Stomach Stomach

C7A.025 Malignant carcinoid tumor of the sigmoid colon Colon Colon Colon Colon Colon

C7A.026 Malignant carcinoid tumor of the rectum Colon Colon Colon Colon Colon

C7A.029 Malignant carcinoid tumor of the large intestine, 

unspecified portion

Stomach Stomach Stomach Stomach Stomach

C7A.090 Malignant carcinoid tumor of the bronchus and 

lung

Lung Lung Lung Lung Lung

C7A.091 Malignant carcinoid tumor of the thymus Thymus Thymus Thymus Thymus Thymus

C7A.092 Malignant carcinoid tumor of the stomach Stomach Stomach Stomach Stomach Stomach

C7A.093 Malignant carcinoid tumor of the kidney Liver Liver Liver Liver Liver

C7A.094 Malignant carcinoid tumor of the foregut, 

unspecified

Remainder Remainder Remainder Remainder Remainder

C7A.095 Malignant carcinoid tumor of the midgut, 

unspecified

Remainder Remainder Remainder Remainder Remainder

C7A.096 Malignant carcinoid tumor of the hindgut, 

unspecified

Remainder Remainder Remainder Remainder Remainder

C7A.098 Malignant carcinoid tumors of other sites Remainder Remainder Remainder Remainder Remainder

C7A.1 Malignant poorly differentiated neuroendocrine 

tumors

Remainder Remainder Remainder Remainder Remainder
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C7A.8 Other malignant neuroendocrine tumors Remainder Remainder Remainder Remainder Remainder

C7B Secondary carcinoid tumors, neuroendocrine 

tumors

Remainder Remainder Remainder Remainder Remainder

C80 Malignant neoplasm, unspecified Remainder Remainder Remainder Remainder Remainder

C81.00 Nodular lymphocyte predominant Hodgkin 

lymphoma, unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.01 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.02 Nodular lymphocyte predominant Hodgkin 

lymphoma, intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C81.03 Nodular lymphocyte predominant Hodgkin 

lymphoma, intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach

C81.04 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.05 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of inguinal region and 

lower limb

Bladder Bladder Bladder Bladder Bladder

C81.06 Nodular lymphocyte predominant Hodgkin 

lymphoma, intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.07 Nodular lymphocyte predominant Hodgkin 

lymphoma, spleen

Stomach Stomach Stomach Stomach Stomach

C81.08 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.09 Nodular lymphocyte predominant Hodgkin 

lymphoma, extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.10 Nodular sclerosis Hodgkin lymphoma, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.11 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.12 Nodular sclerosis Hodgkin lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C81.13 Nodular sclerosis Hodgkin lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C81.14 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C81.15 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.16 Nodular sclerosis Hodgkin lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.17 Nodular sclerosis Hodgkin lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C81.18 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.19 Nodular sclerosis Hodgkin lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.20 Mixed cellularity Hodgkin lymphoma, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.21 Mixed cellularity Hodgkin lymphoma, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.22 Mixed cellularity Hodgkin lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C81.23 Mixed cellularity Hodgkin lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C81.24 Mixed cellularity Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.25 Mixed cellularity Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.26 Mixed cellularity Hodgkin lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.27 Mixed cellularity Hodgkin lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C81.28 Mixed cellularity Hodgkin lymphoma, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.29 Mixed cellularity Hodgkin lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.30 Lymphocyte depleted Hodgkin lymphoma, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.31 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.32 Lymphocyte depleted Hodgkin lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C81.33 Lymphocyte depleted Hodgkin lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C81.34 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.35 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.36 Lymphocyte depleted Hodgkin lymphoma, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.37 Lymphocyte depleted Hodgkin lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C81.38 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.39 Lymphocyte depleted Hodgkin lymphoma, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.40 Lymphocyte-rich Hodgkin lymphoma, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.41 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.42 Lymphocyte-rich Hodgkin lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C81.43 Lymphocyte-rich Hodgkin lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C81.44 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.45 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.46 Lymphocyte-rich Hodgkin lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.47 Lymphocyte-rich Hodgkin lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C81.48 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.49 Lymphocyte-rich Hodgkin lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.70 Other Hodgkin lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.71 Other Hodgkin lymphoma, lymph nodes of head, 

face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.72 Other Hodgkin lymphoma, intrathoracic lymph 

nodes

Lung Lung Lung Lung Lung
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C81.73 Other Hodgkin lymphoma, intra-abdominal lymph 

nodes

Stomach Stomach Stomach Stomach Stomach

C81.74 Other Hodgkin lymphoma, lymph nodes of axilla 

and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.75 Other Hodgkin lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.76 Other Hodgkin lymphoma, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C81.77 Other Hodgkin lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C81.78 Other Hodgkin lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.79 Other Hodgkin lymphoma, extranodal and solid 

organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.90 Hodgkin lymphoma, unspecified, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.91 Hodgkin lymphoma, unspecified, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C81.92 Hodgkin lymphoma, unspecified, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C81.93 Hodgkin lymphoma, unspecified, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C81.94 Hodgkin lymphoma, unspecified, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C81.95 Hodgkin lymphoma, unspecified, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C81.96 Hodgkin lymphoma, unspecified, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C81.97 Hodgkin lymphoma, unspecified, spleen Stomach Stomach Stomach Stomach Stomach

C81.98 Hodgkin lymphoma, unspecified, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C81.99 Hodgkin lymphoma, unspecified, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.00 Follicular lymphoma grade I, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.01 Follicular lymphoma grade I, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C82.02 Follicular lymphoma grade I, intrathoracic lymph 

nodes

Lung Lung Lung Lung Lung

C82.03 Follicular lymphoma grade I, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C82.04 Follicular lymphoma grade I, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.05 Follicular lymphoma grade I, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.06 Follicular lymphoma grade I, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C82.07 Follicular lymphoma grade I, spleen Stomach Stomach Stomach Stomach Stomach

C82.08 Follicular lymphoma grade I, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.09 Follicular lymphoma grade I, extranodal and solid 

organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.10 Follicular lymphoma grade II, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.11 Follicular lymphoma grade II, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.12 Follicular lymphoma grade II, intrathoracic lymph 

nodes

Lung Lung Lung Lung Lung

C82.13 Follicular lymphoma grade II, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C82.14 Follicular lymphoma grade II, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.15 Follicular lymphoma grade II, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.16 Follicular lymphoma grade II, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C82.17 Follicular lymphoma grade II, spleen Stomach Stomach Stomach Stomach Stomach

C82.18 Follicular lymphoma grade II, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.19 Follicular lymphoma grade II, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.20 Follicular lymphoma grade III, unspecified, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C82.21 Follicular lymphoma grade III, unspecified, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.22 Follicular lymphoma grade III, unspecified, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C82.23 Follicular lymphoma grade III, unspecified, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C82.24 Follicular lymphoma grade III, unspecified, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.25 Follicular lymphoma grade III, unspecified, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.26 Follicular lymphoma grade III, unspecified, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C82.27 Follicular lymphoma grade III, unspecified, 

spleen

Stomach Stomach Stomach Stomach Stomach

C82.28 Follicular lymphoma grade III, unspecified, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.29 Follicular lymphoma grade III, unspecified, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.30 Follicular lymphoma grade IIIa, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.31 Follicular lymphoma grade IIIa, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.32 Follicular lymphoma grade IIIa, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.33 Follicular lymphoma grade IIIa, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C82.34 Follicular lymphoma grade IIIa, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.35 Follicular lymphoma grade IIIa, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.36 Follicular lymphoma grade IIIa, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C82.37 Follicular lymphoma grade IIIa, spleen Stomach Stomach Stomach Stomach Stomach

C82.38 Follicular lymphoma grade IIIa, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C82.39 Follicular lymphoma grade IIIa, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.40 Follicular lymphoma grade IIIb, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.41 Follicular lymphoma grade IIIb, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.42 Follicular lymphoma grade IIIb, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.43 Follicular lymphoma grade IIIb, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C82.44 Follicular lymphoma grade IIIb, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.45 Follicular lymphoma grade IIIb, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.46 Follicular lymphoma grade IIIb, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C82.47 Follicular lymphoma grade IIIb, spleen Stomach Stomach Stomach Stomach Stomach

C82.48 Follicular lymphoma grade IIIb, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.49 Follicular lymphoma grade IIIb, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.50 Diffuse follicle center lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.51 Diffuse follicle center lymphoma, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.52 Diffuse follicle center lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.53 Diffuse follicle center lymphoma, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C82.54 Diffuse follicle center lymphoma, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.55 Diffuse follicle center lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.56 Diffuse follicle center lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C82.57 Diffuse follicle center lymphoma, spleen Stomach Stomach Stomach Stomach Stomach
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C82.58 Diffuse follicle center lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.59 Diffuse follicle center lymphoma, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.60 Cutaneous follicle center lymphoma, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.61 Cutaneous follicle center lymphoma, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.62 Cutaneous follicle center lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.63 Cutaneous follicle center lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C82.64 Cutaneous follicle center lymphoma, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.65 Cutaneous follicle center lymphoma, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.66 Cutaneous follicle center lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C82.67 Cutaneous follicle center lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C82.68 Cutaneous follicle center lymphoma, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.69 Cutaneous follicle center lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.80 Other types of follicular lymphoma, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.81 Other types of follicular lymphoma, lymph nodes 

of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.82 Other types of follicular lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.83 Other types of follicular lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C82.84 Other types of follicular lymphoma, lymph nodes 

of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.85 Other types of follicular lymphoma, lymph nodes 

of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C82.86 Other types of follicular lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C82.87 Other types of follicular lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C82.88 Other types of follicular lymphoma, lymph nodes 

of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.89 Other types of follicular lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.90 Follicular lymphoma, unspecified, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.91 Follicular lymphoma, unspecified, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C82.92 Follicular lymphoma, unspecified, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C82.93 Follicular lymphoma, unspecified, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C82.94 Follicular lymphoma, unspecified, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C82.95 Follicular lymphoma, unspecified, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C82.96 Follicular lymphoma, unspecified, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C82.97 Follicular lymphoma, unspecified, spleen Stomach Stomach Stomach Stomach Stomach

C82.98 Follicular lymphoma, unspecified, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C82.99 Follicular lymphoma, unspecified, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.00 Small cell B-cell lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.01 Small cell B-cell lymphoma, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.02 Small cell B-cell lymphoma, intrathoracic lymph 

nodes

Lung Lung Lung Lung Lung

C83.03 Small cell B-cell lymphoma, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C83.04 Small cell B-cell lymphoma, lymph nodes of axilla 

and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C83.05 Small cell B-cell lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.06 Small cell B-cell lymphoma, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C83.07 Small cell B-cell lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.08 Small cell B-cell lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.09 Small cell B-cell lymphoma, extranodal and solid 

organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.10 Mantle cell lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.11 Mantle cell lymphoma, lymph nodes of head, 

face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.12 Mantle cell lymphoma, intrathoracic lymph nodes Lung Lung Lung Lung Lung

C83.13 Mantle cell lymphoma, intra-abdominal lymph 

nodes

Stomach Stomach Stomach Stomach Stomach

C83.14 Mantle cell lymphoma, lymph nodes of axilla and 

upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C83.15 Mantle cell lymphoma, lymph nodes of inguinal 

region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.16 Mantle cell lymphoma, intrapelvic lymph nodes Bladder Bladder Bladder Bladder Bladder

C83.17 Mantle cell lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.18 Mantle cell lymphoma, lymph nodes of multiple 

sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.19 Mantle cell lymphoma, extranodal and solid 

organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.30 Diffuse large B-cell lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.31 Diffuse large B-cell lymphoma, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.32 Diffuse large B-cell lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C83.33 Diffuse large B-cell lymphoma, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C83.34 Diffuse large B-cell lymphoma, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C83.35 Diffuse large B-cell lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.36 Diffuse large B-cell lymphoma, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C83.37 Diffuse large B-cell lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.38 Diffuse large B-cell lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.39 Diffuse large B-cell lymphoma, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.50 Lymphoblastic (diffuse) lymphoma, unspecified 

site

See Tables A-2 and

A-3

Lung Lung Thyroid Lung

C83.51 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.52 Lymphoblastic (diffuse) lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C83.53 Lymphoblastic (diffuse) lymphoma, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C83.54 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C83.55 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.56 Lymphoblastic (diffuse) lymphoma, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C83.57 Lymphoblastic (diffuse) lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.58 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.59 Lymphoblastic (diffuse) lymphoma, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.70 Burkitt lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.71 Burkitt lymphoma, lymph nodes of head, face, 

and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.72 Burkitt lymphoma, intrathoracic lymph nodes Lung Lung Lung Lung Lung

C83.73 Burkitt lymphoma, intra-abdominal lymph nodes Stomach Stomach Stomach Stomach Stomach

C83.74 Burkitt lymphoma, lymph nodes of axilla and 

upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C83.75 Burkitt lymphoma, lymph nodes of inguinal region 

and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.76 Burkitt lymphoma, intrapelvic lymph nodes Bladder Bladder Bladder Bladder Bladder

C83.77 Burkitt lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.78 Burkitt lymphoma, lymph nodes of multiple sites See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.79 Burkitt lymphoma, extranodal and solid organ 

sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.80 Other non-follicular lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.81 Other non-follicular lymphoma, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.82 Other non-follicular lymphoma, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C83.83 Other non-follicular lymphoma, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C83.84 Other non-follicular lymphoma, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C83.85 Other non-follicular lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.86 Other non-follicular lymphoma, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C83.87 Other non-follicular lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C83.88 Other non-follicular lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.89 Other non-follicular lymphoma, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.90 Non-follicular (diffuse) lymphoma, unspecified, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.91 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C83.92 Non-follicular (diffuse) lymphoma, unspecified, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C83.93 Non-follicular (diffuse) lymphoma, unspecified, 

intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C83.94 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C83.95 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C83.96 Non-follicular (diffuse) lymphoma, unspecified, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C83.97 Non-follicular (diffuse) lymphoma, unspecified, 

spleen

Stomach Stomach Stomach Stomach Stomach

C83.98 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C83.99 Non-follicular (diffuse) lymphoma, unspecified, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.00 Mycosis fungoides, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.01 Mycosis fungoides, lymph nodes of head, face, 

and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.02 Mycosis fungoides, intrathoracic lymph nodes Lung Lung Lung Lung Lung

C84.03 Mycosis fungoides, intra-abdominal lymph nodes Stomach Stomach Stomach Stomach Stomach

C84.04 Mycosis fungoides, lymph nodes of axilla and 

upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.05 Mycosis fungoides, lymph nodes of inguinal 

region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.06 Mycosis fungoides, intrapelvic lymph nodes Bladder Bladder Bladder Bladder Bladder

C84.07 Mycosis fungoides, spleen Stomach Stomach Stomach Stomach Stomach

C84.08 Mycosis fungoides, lymph nodes of multiple sites See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.09 Mycosis fungoides, extranodal and solid organ 

sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.10 Sezary disease, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.11 Sezary disease, lymph nodes of head, face, and 

neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.12 Sezary disease, intrathoracic lymph nodes Lung Lung Lung Lung Lung

C84.13 Sezary disease, intra-abdominal lymph nodes Stomach Stomach Stomach Stomach Stomach

C84.14 Sezary disease, lymph nodes of axilla and upper 

limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C84.15 Sezary disease, lymph nodes of inguinal region 

and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.16 Sezary disease, intrapelvic lymph nodes Bladder Bladder Bladder Bladder Bladder

C84.17 Sezary disease, spleen Stomach Stomach Stomach Stomach Stomach

C84.18 Sezary disease, lymph nodes of multiple sites See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.19 Sezary disease, extranodal and solid organ sites See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.40 Peripheral T-cell lymphoma, not classified, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.41 Peripheral T-cell lymphoma, not classified, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.42 Peripheral T-cell lymphoma, not classified, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C84.43 Peripheral T-cell lymphoma, not classified, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C84.44 Peripheral T-cell lymphoma, not classified, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.45 Peripheral T-cell lymphoma, not classified, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.46 Peripheral T-cell lymphoma, not classified, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C84.47 Peripheral T-cell lymphoma, not classified, 

spleen

Stomach Stomach Stomach Stomach Stomach

C84.48 Peripheral T-cell lymphoma, not classified, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.49 Peripheral T-cell lymphoma, not classified, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.60 Anaplastic large cell lymphoma, ALK-positive, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.61 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.62 Anaplastic large cell lymphoma, ALK-positive, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C84.63 Anaplastic large cell lymphoma, ALK-positive, 

intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C84.64 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.65 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.66 Anaplastic large cell lymphoma, ALK-positive, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C84.67 Anaplastic large cell lymphoma, ALK-positive, 

spleen

Stomach Stomach Stomach Stomach Stomach

C84.68 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.69 Anaplastic large cell lymphoma, ALK-positive, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.70 Anaplastic large cell lymphoma, ALK-negative, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.71 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.72 Anaplastic large cell lymphoma, ALK-negative, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C84.73 Anaplastic large cell lymphoma, ALK-negative, 

intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach

C84.74 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.75 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.76 Anaplastic large cell lymphoma, ALK-negative, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C84.77 Anaplastic large cell lymphoma, ALK-negative, 

spleen

Stomach Stomach Stomach Stomach Stomach

C84.78 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.79 Anaplastic large cell lymphoma, ALK-negative, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.90 Mature T/NK-cell lymphomas, unspecified, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.91 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid
ATTACHMENT A

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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C84.92 Mature T/NK-cell lymphomas, unspecified, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C84.93 Mature T/NK-cell lymphomas, unspecified, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C84.94 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.95 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.96 Mature T/NK-cell lymphomas, unspecified, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C84.97 Mature T/NK-cell lymphomas, unspecified, 

spleen

Stomach Stomach Stomach Stomach Stomach

C84.98 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.99 Mature T/NK-cell lymphomas, unspecified, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.A Cutaneous T-cell lymphoma See Tables B-4 and

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

C84.Z0 Other mature T/NK-cell lymphomas, unspecified 

site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C84.Z1 Other mature T/NK-cell lymphomas, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C84.Z2 Other mature T/NK-cell lymphomas, intrathoracic 

lymph nodes

Lung Lung Lung Lung Lung

C84.Z3 Other mature T/NK-cell lymphomas, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C84.Z4 Other mature T/NK-cell lymphomas, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C84.Z5 Other mature T/NK-cell lymphomas, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C84.Z6 Other mature T/NK-cell lymphomas, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C84.Z7 Other mature T/NK-cell lymphomas, spleen Stomach Stomach Stomach Stomach Stomach

C84.Z8 Other mature T/NK-cell lymphomas, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C84.Z9 Other mature T/NK-cell lymphomas, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.10 Unspecified B-cell lymphoma, unspecified site See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.11 Unspecified B-cell lymphoma, lymph nodes of 

head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C85.12 Unspecified B-cell lymphoma, intrathoracic lymph 

nodes

Lung Lung Lung Lung Lung

C85.13 Unspecified B-cell lymphoma, intra-abdominal 

lymph nodes

Stomach Stomach Stomach Stomach Stomach

C85.14 Unspecified B-cell lymphoma, lymph nodes of 

axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C85.15 Unspecified B-cell lymphoma, lymph nodes of 

inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C85.16 Unspecified B-cell lymphoma, intrapelvic lymph 

nodes

Bladder Bladder Bladder Bladder Bladder

C85.17 Unspecified B-cell lymphoma, spleen Stomach Stomach Stomach Stomach Stomach

C85.18 Unspecified B-cell lymphoma, lymph nodes of 

multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.19 Unspecified B-cell lymphoma, extranodal and 

solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.20 Mediastinal (thymic) large B-cell lymphoma, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.21 Mediastinal (thymic) large B-cell lymphoma, 

lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C85.22 Mediastinal (thymic) large B-cell lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C85.23 Mediastinal (thymic) large B-cell lymphoma, 

intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach

C85.24 Mediastinal (thymic) large B-cell lymphoma, 

lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C85.25 Mediastinal (thymic) large B-cell lymphoma, 

lymph nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C85.26 Mediastinal (thymic) large B-cell lymphoma, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C85.27 Mediastinal (thymic) large B-cell lymphoma, 

spleen

Stomach Stomach Stomach Stomach Stomach

C85.28 Mediastinal (thymic) large B-cell lymphoma, 

lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.29 Mediastinal (thymic) large B-cell lymphoma, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.80 Other specified types of non-Hodgkin lymphoma, 

unspecified site

See Tables A-2 and

A-3

Lung Lung Thyroid Lung

C85.81 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C85.82 Other specified types of non-Hodgkin lymphoma, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C85.83 Other specified types of non-Hodgkin lymphoma, 

intra-abdominal lymph nodes

Stomach Stomach Stomach Stomach Stomach

C85.84 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast

C85.85 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C85.86 Other specified types of non-Hodgkin lymphoma, 

intrapelvic lymph nodes

Bladder Bladder Bladder Bladder Bladder

C85.87 Other specified types of non-Hodgkin lymphoma, 

spleen

Stomach Stomach Stomach Stomach Stomach

C85.88 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.89 Other specified types of non-Hodgkin lymphoma, 

extranodal and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.90 Non-Hodgkin lymphoma, unspecified, 

unspecified site

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.91 Non-Hodgkin lymphoma, unspecified, lymph 

nodes of head, face, and neck

Thyroid Thyroid Thyroid Thyroid Thyroid

C85.92 Non-Hodgkin lymphoma, unspecified, 

intrathoracic lymph nodes

Lung Lung Lung Lung Lung

C85.93 Non-Hodgkin lymphoma, unspecified, intraabdominal lymph nodesStomach Stomach Stomach Stomach Stomach

C85.94 Non-Hodgkin lymphoma, unspecified, lymph 

nodes of axilla and upper limb

See Tables A-2 and 

A-3

Lung Breast Lung Breast
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C85.95 Non-Hodgkin lymphoma, unspecified, lymph 

nodes of inguinal region and lower limb

Bladder Bladder Bladder Bladder Bladder

C85.96 Non-Hodgkin lymphoma, unspecified, intrapelvic 

lymph nodes

Bladder Bladder Bladder Bladder Bladder

C85.97 Non-Hodgkin lymphoma, unspecified, spleen Stomach Stomach Stomach Stomach Stomach

C85.98 Non-Hodgkin lymphoma, unspecified, lymph 

nodes of multiple sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C85.99 Non-Hodgkin lymphoma, unspecified, extranodal 

and solid organ sites

See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C86.0 Extranodal NK/T-cell lymphoma, nasal type Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

C86.1 Hepatosplenic T-cell lymphoma Liver Liver Liver Liver Liver

C86.2 Enteropathy-type (intestinal) T-cell lymphoma Colon Colon Colon Colon Colon

C86.3 Subcutaneous panniculitis-like T-cell lymphoma Lung Lung Lung Lung Lung

C86.4 Blastic NK-cell lymphoma Lung Lung Lung Lung Lung

C86.5 Angioimmunoblastic T-cell lymphoma Lung Lung Lung Lung Lung

C86.6 Primary cutaneous CD30-positive T-cell 

proliferations

ENSD ENSD ENSD ENSD ENSD

C88.0 Waldenstrom macroglobulinemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C88.2 Heavy chain disease Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C88.3 Immunoproliferative small intestinal disease Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C88.4 Extranodal marginal zone B-cell lymphoma of 

mucosa-associated lymphoid tissue [MALTlymphoma]

Lung Lung Lung Lung Lung

C88.8 Other malignant immunoproliferative diseases Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C88.9 Malignant immunoproliferative disease, 

unspecified

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C90 Multiple myeloma and malignant plasma cell 

neoplasms

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C90.32 Solitary plasmacytoma in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C91 Leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C92 Leukemia, myeloid sarcoma Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C93 Leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C94 panmyelosis Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C95 Leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

C96.0 Multifocal and multisystemic (disseminated) 

Langerhans-cell histiocytosis

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C96.20 Malignant mast cell neoplasm, unspecified See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.20 Malignant mast cell neoplasm, head Thyroid Thyroid Thyroid Thyroid Thyroid

C96.20 Malignant mast cell neoplasm, thorax Lung Lung Lung Lung Lung

C96.20 Malignant mast cell neoplasm, abdom Stomach Stomach Stomach Stomach Stomach

C96.20 Malignant mast cell neoplasm, axilla See Tables A-2 and 

A-3

Lung Breast Lung Breast

C96.20 Malignant mast cell neoplasm, inguin Bladder Bladder Bladder Bladder Bladder

C96.20 Malignant mast cell neoplasm, pelvic Bladder Bladder Bladder Bladder Bladder

C96.20 Malignant mast cell neoplasm, spleen Stomach Stomach Stomach Stomach Stomach

C96.20 Malignant mast cell neoplasm, multiple See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.21 Aggressive systemic mastocytosis, unspecified See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.21 Aggressive systemic mastocytosis, head Thyroid Thyroid Thyroid Thyroid Thyroid

C96.21 Aggressive systemic mastocytosis, thorax Lung Lung Lung Lung Lung

C96.21 Aggressive systemic mastocytosis, abdom Stomach Stomach Stomach Stomach Stomach

C96.21 Aggressive systemic mastocytosis, axilla See Tables A-2 and 

A-3

Lung Breast Lung Breast

C96.21 Aggressive systemic mastocytosis, inguin Bladder Bladder Bladder Bladder Bladder

C96.21 Aggressive systemic mastocytosis, pelvic Bladder Bladder Bladder Bladder Bladder

C96.21 Aggressive systemic mastocytosis, spleen Stomach Stomach Stomach Stomach Stomach

C96.21 Aggressive systemic mastocytosis, multiple See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.22 Mast cell sarcoma, unspecified See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.22 Mast cell sarcoma, head Thyroid Thyroid Thyroid Thyroid Thyroid

C96.22 Mast cell sarcoma, thorax Lung Lung Lung Lung Lung

C96.22 Mast cell sarcoma, abdom Stomach Stomach Stomach Stomach Stomach

C96.22 Mast cell sarcoma, axilla See Tables A-2 and 

A-3

Lung Breast Lung Breast

C96.22 Mast cell sarcoma, inguin Bladder Bladder Bladder Bladder Bladder

C96.22 Mast cell sarcoma, pelvic Bladder Bladder Bladder Bladder Bladder

C96.22 Mast cell sarcoma, spleen Stomach Stomach Stomach Stomach Stomach

C96.22 Mast cell sarcoma, multiple See Tables A-2 and 

A-3

Lung Lung Thyroid Lung
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

C96.29 Other malignant mast cell neoplasm, unspecified See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.29 Other malignant mast cell neoplasm, head Thyroid Thyroid Thyroid Thyroid Thyroid

C96.29 Other malignant mast cell neoplasm, thorax Lung Lung Lung Lung Lung

C96.29 Other malignant mast cell neoplasm, abdom Stomach Stomach Stomach Stomach Stomach

C96.29 Other malignant mast cell neoplasm, axilla See Tables A-2 and 

A-3

Lung Breast Lung Breast

C96.29 Other malignant mast cell neoplasm, inguin Bladder Bladder Bladder Bladder Bladder

C96.29 Other malignant mast cell neoplasm, pelvic Bladder Bladder Bladder Bladder Bladder

C96.29 Other malignant mast cell neoplasm, spleen Stomach Stomach Stomach Stomach Stomach

C96.29 Other malignant mast cell neoplasm, multiple See Tables A-2 and 

A-3

Lung Lung Thyroid Lung

C96.4 Sarcoma of dendritic cells (accessory cells) Lung Lung Lung Thyroid Lung

C96.9 Malignant neoplasm of lymphoid, hematopoietic 

and related tissue, unspecified

Lung Lung Lung Lung Lung

C96.A Histiocytic sarcoma Thyroid Thyroid Thyroid Thyroid Thyroid

C96.Z Other specified malignant neoplasms of 

lymphoid, hematopoietic and related tissue

Lung Lung Lung Lung Lung

D00.0 Carcinoma in situ of oral cavity Thyroid Thyroid Thyroid Thyroid Thyroid

D00.1 Carcinoma in situ of esophagus Stomach Stomach Stomach Stomach Stomach

D00.2 Carcinoma in situ of stomach Stomach Stomach Stomach Stomach Stomach

D01.0 Carcinoma in situ of colon Stomach Stomach Stomach Stomach Stomach

D01.1 Carcinoma in situ of rectosigmoid junction Colon Colon Colon Colon Colon

D01.2 Carcinoma in situ of rectum Colon Colon Colon Colon Colon

D01.3 Carcinoma in situ of anus and anal canal Colon Colon Colon Colon Colon

D01.4 Carcinoma in situ of part of intestine Stomach Stomach Stomach Stomach Stomach

D01.5 Carcinoma in situ of liver, gallbladder and bile 

ducts

Liver Liver Liver Liver Liver

D01.7 Carcinoma in situ of other specified digestive 

organs

Stomach Stomach Stomach Stomach Stomach

D01.9 Carcinoma in situ of digestive organ, unspecified Stomach Stomach Stomach Stomach Stomach

D02.0 Carcinoma in situ of larynx Thyroid Thyroid Thyroid Thyroid Thyroid

D02.1 Carcinoma in situ of trachea Thyroid Thyroid Thyroid Thyroid Thyroid

D02.2 Carcinoma in situ of bronchus and lung Lung Lung Lung Lung Lung

D02.3 Carcinoma in situ of other parts of respiratory 

system

Lung Lung Lung Lung Lung
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code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

D02.4 Carcinoma in situ of respiratory system, 

unspecified

Lung Lung Lung Lung Lung

D03.0 Melanoma in situ of lip See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

D03.1 Melanoma in situ of eyelid, including canthus See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.2 Melanoma in situ of ear and external auricular 

canal

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.3 Melanoma in situ of face See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.4 Melanoma in situ of scalp and neck See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.5 Melanoma in situ of anal skin, breast, trunk See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.6 Melanoma in situ of upper limb, including 

shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.7 Melanoma in situ of lower limb, including hip See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.8 Melanoma in situ of other sites See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D03.9 Melanoma in situ, unspecified See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.0 Carcinoma in situ of skin of lip See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

D04.1 Carcinoma in situ of skin of eyelid, including 

canthus

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.2 Carcinoma in situ of skin of ear and external 

auricular canal

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.3 Carcinoma in situ of skin of part of face See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.4 Carcinoma in situ of skin of scalp and neck See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.5 Carcinoma in situ of skin of trunk See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.6 Carcinoma in situ of skin of upper limb, including 

shoulder

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5
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Thoracic 

spine Cervical spine Pelvis

D04.7 Carcinoma in situ of skin of lower limb, including 

hip

See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.8 Carcinoma in situ of skin of other sites See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D04.9 Carcinoma in situ of skin, unspecified See Tables B-4 and 

B-8

See Tables B5 and B-9See Table B-6 See Table B-7 See Table B-5

D05 Lobular carcinoma in situ of breast Breast Breast Breast Breast Breast

D06 Carcinoma in situ of cervix Uterus Uterus Uterus Uterus Uterus

D07 Carcinoma in situ of female genital organs Uterus Uterus Uterus Uterus Uterus

D07.4 Carcinoma in situ of penis Testes Testes Testes Testes Testes

D07.5 Carcinoma in situ of prostate Bladder Bladder Bladder Bladder Bladder

D07.6 Carcinoma in situ of male genital organs Testes Testes Testes Testes Testes

D09.0 Carcinoma in situ of bladder Bladder Bladder Bladder Bladder Bladder

D09.1 Carcinoma in situ of urinary organ Bladder Bladder Bladder Bladder Bladder

D09.2 Carcinoma in situ of eye Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (thyroid)

Thyroid Thyroid Thyroid Thyroid Thyroid

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (adrenal)

Remainder Remainder Remainder Remainder Remainder

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (parathyroid)

Thyroid Thyroid Thyroid Thyroid Thyroid

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (pituitary)

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (pineal gland)

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (carotid body)

Thyroid Thyroid Thyroid Thyroid Thyroid

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (paraganglia NEC)

Remainder Remainder Remainder Remainder Remainder

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (endocrine NEC)

Remainder Remainder Remainder Eye/brain Remainder

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (endocrine NOS)

Remainder Remainder Remainder Eye/brain Remainder

D09.8 Carcinoma in situ of other specified sites Remainder Remainder Remainder Remainder Remainder

D09.9 Carcinoma in situ, unspecified Remainder Remainder Remainder Remainder Remainder
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Thoracic 

spine Cervical spine Pelvis

D37.01 Neoplasm of uncertain behavior of lip See Tables A-2 and 

A-3

Eye/brain See Table A5ENSD Eye/brain

D37.02 Neoplasm of uncertain behavior of tongue Thyroid Thyroid Thyroid Thyroid Thyroid

D37.03 Neoplasm of uncertain behavior of the salivary 

glands

Thyroid Thyroid Thyroid Thyroid Thyroid

D37.04 Neoplasm of uncertain behavior of the minor 

salivary glands

Thyroid Thyroid Thyroid Thyroid Thyroid

D37.05 Neoplasm of uncertain behavior of pharynx Thyroid Thyroid Thyroid Thyroid Thyroid

D37.09 Neoplasm of uncertain behavior of other 

specified sites of the oral cavity

Thyroid Thyroid Thyroid Thyroid Thyroid

D37.1 Neoplasm of uncertain behavior of stomach Stomach Stomach Stomach Stomach Stomach

D37.2 Neoplasm of uncertain behavior of small intestine Stomach Stomach Stomach Stomach Stomach

D37.3 Neoplasm of uncertain behavior of appendix Colon Colon Colon Colon Colon

D37.4 Neoplasm of uncertain behavior of colon Stomach Colon Stomach Stomach Stomach

D37.5 Neoplasm of uncertain behavior of rectum Colon Colon Colon Colon Colon

D37.6 Neoplasm of uncertain behavior of liver, 

gallbladder and bile ducts

Liver Liver Liver Liver Liver

D37.8 Neoplasm of uncertain behavior of other 

specified digestive organs

Stomach Colon Stomach Stomach Stomach

D37.9 Neoplasm of uncertain behavior of digestive 

organ, unspecified

Stomach Colon Stomach Stomach Stomach

D38.0 Neoplasm of uncertain behavior of larynx Esophagus Esophagus Esophagus Esophagus Esophagus

D38.1 Neoplasm of uncertain behavior of trachea, 

bronchus and lung

Lung Lung Lung Lung Lung

D38.2 Neoplasm of uncertain behavior of pleura Lung Lung Lung Lung Lung

D38.3 Neoplasm of uncertain behavior of mediastinum Lung Lung Lung Lung Lung

D38.4 Neoplasm of uncertain behavior of thymus Thymus Thymus Thymus Thymus Thymus

D38.5 Neoplasm of uncertain behavior of other 

respiratory organs

Lung Lung Lung Lung Lung

D38.6 Neoplasm of uncertain behavior of respiratory 

organ, unspecified

Lung Lung Lung Lung Lung

D39.0 Neoplasm of uncertain behavior of uterus Uterus Uterus Uterus Uterus Uterus

D39.10 Neoplasm of uncertain behavior of unspecified 

ovary

Ovaries Ovaries Ovaries Ovaries Ovaries

D39.11 Neoplasm of uncertain behavior of right ovary Ovaries Ovaries Ovaries Ovaries Ovaries

D39.12 Neoplasm of uncertain behavior of left ovary Ovaries Ovaries Ovaries Ovaries Ovaries
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

D39.2 Neoplasm of uncertain behavior of placenta Uterus Uterus Uterus Uterus Uterus

D39.8 Neoplasm of uncertain behavior of other 

specified female genital organs

Uterus Uterus Uterus Uterus Uterus

D39.9 Neoplasm of uncertain behavior of female genital 

organ, unspecified

Uterus Uterus Uterus Uterus Uterus

D40.0 Neoplasm of uncertain behavior of prostate Bladder Bladder Bladder Bladder Bladder

D40.1 Neoplasm of uncertain behavior of testis Testes Testes Testes Testes Testes

D40.8 Neoplasm of uncertain behavior of other 

specified male genital organs

Testes Testes Testes Testes Testes

D40.9 Neoplasm of uncertain behavior of male genital 

organ, unspecified

Testes Testes Testes Testes Testes

D41.0 Neoplasm of uncertain behavior of kidney Liver Liver Liver Liver Liver

D41.1 Neoplasm of uncertain behavior of renal pelvis Liver Liver Liver Liver Liver

D41.2 Neoplasm of uncertain behavior of ureter Liver Liver Liver Liver Liver

D41.3 Neoplasm of uncertain behavior of urethra Liver Liver Liver Liver Liver

D41.4 Neoplasm of uncertain behavior of bladder Bladder Bladder Bladder Bladder Bladder

D41.8 Neoplasm of uncertain behavior of other 

specified urinary organs

Liver Liver Liver Liver Liver

D41.9 Neoplasm of uncertain behavior of unspecified 

urinary organ

Liver Liver Liver Liver Liver

D42.0 Neoplasm of uncertain behavior of cerebral 

meninges

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D42.1 Neoplasm of uncertain behavior of spinal 

meninges

Remainder Remainder Remainder Remainder Remainder

D42.9 Neoplasm of uncertain behavior of meninges, 

unspecified

Remainder Remainder Remainder Remainder Remainder

D43.0 Neoplasm of uncertain behavior of brain, 

supratentorial

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D43.1 Neoplasm of uncertain behavior of brain, 

infratentorial

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D43.2 Neoplasm of uncertain behavior of brain, 

unspecified

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D43.3 Neoplasm of uncertain behavior of cranial nerves Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D43.4 Neoplasm of uncertain behavior of spinal cord Remainder Remainder Remainder Remainder Remainder

D43.8 Neoplasm of uncertain behavior of other 

specified parts of central nervous system

Remainder Remainder Remainder Remainder Remainder
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

D43.9 Neoplasm of uncertain behavior of central 

nervous system, unspecified

Remainder Remainder Remainder Remainder Remainder

D44.0 Neoplasm of uncertain behavior of thyroid gland Thyroid Thyroid Thyroid Thyroid Thyroid

D44.1 Neoplasm of uncertain behavior of adrenal gland Remainder Remainder Remainder Remainder Remainder

D44.2 Neoplasm of uncertain behavior of parathyroid 

gland

Thyroid Thyroid Thyroid Thyroid Thyroid

D44.3 Neoplasm of uncertain behavior of pituitary gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D44.4 Neoplasm of uncertain behavior of 

craniopharyngeal duct

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D44.5 Neoplasm of uncertain behavior of pineal gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D44.6 Neoplasm of uncertain behavior of carotid body Thyroid Thyroid Thyroid Thyroid Thyroid

D44.7 Neoplasm of uncertain behavior of aortic body 

and other paraganglia

Remainder Remainder Remainder Remainder Remainder

D44.9 Neoplasm of uncertain behavior of unspecified 

endocrine gland

Remainder Remainder Remainder Eye/brain Remainder

D45 Polycythemia vera Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D46 Refractory anemia, Myelodysplastic syndrome, 

Refractory cytopenia

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.01 Cutaneous mastocytosis ENSD ENSD ENSD ENSD ENSD

D47.02 Systemic mastocytosis Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.09 Other mast cell neoplasms of uncertain behavior Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.1 Chronic myeloproliferative disease Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.3 Essential (hemorrhagic) thrombocythemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.4 Osteomyelofibrosis Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.9 Neoplasm of uncertain behavior of lymphoid, 

hematopoietic and related tissue, unspecified

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.Z2 Castleman disease Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D47.Z9 Other specified neoplasms of uncertain behavior 

of lymphoid, hematopoietic and related tissue

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D48.0 Neoplasm of uncertain behavior of bone and 

articular cartilage

Bone surface Bone surface Bone surface Bone surface Bone surface

D48.1 Neoplasm of uncertain behavior of connective 

and other soft tissue

Remainder Remainder Remainder Remainder Remainder

D48.2 Neoplasm of uncertain behavior of peripheral 

nerves and autonomic nervous system

Remainder Remainder Remainder Remainder Remainder
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

D48.3 Neoplasm of uncertain behavior of 

retroperitoneum

Stomach Stomach Stomach Stomach Stomach

D48.4 Neoplasm of uncertain behavior of peritoneum Stomach Stomach Stomach Stomach Stomach

D48.5 Neoplasm of uncertain behavior of skin ENSD ENSD ENSD ENSD ENSD

D48.60 Neoplasm of uncertain behavior of unspecified 

breast

Breast Breast Breast Breast Breast

D48.61 Neoplasm of uncertain behavior of right breast Breast Breast Breast Breast Breast

D48.62 Neoplasm of uncertain behavior of left breast Breast Breast Breast Breast Breast

D48.7 Neoplasm of uncertain behavior of other 

specified sites

Remainder Remainder Remainder Remainder Remainder

D48.9 Neoplasm of uncertain behavior, unspecified Remainder Remainder Remainder Remainder Remainder

D49.0 Neoplasm of unspecified behavior of digestive 

system

Stomach Stomach Stomach Stomach Stomach

D49.1 Neoplasm of unspecified behavior of respiratory 

system

Lung Lung Lung Lung Lung

D49.2 Neoplasm of unspecified behavior of bone/skin 

(bone)

Bone surface Bone surface Bone surface Bone surface Bone surface

D49.2 Neoplasm of unspecified behavior of bone/skin 

(skin)

ENSD ENSD ENSD ENSD ENSD

D49.3 Neoplasm of unspecified behavior of breast Breast Breast Breast Breast Breast

D49.4 Neoplasm of unspecified behavior of bladder Bladder Bladder Bladder Bladder Bladder

D49.51 Neoplasm of unspecified behavior of kidney Liver Liver Liver Liver Liver

D49.59 Neoplasm of unspecified behavior of other 

genitourinary organ 

Bladder Bladder Bladder Bladder Bladder

D49.6 Neoplasm of unspecified behavior of brain Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D49.7 Neoplasm of unspecified behavior of other parts 

of nervous system

Remainder Remainder Remainder Remainder Remainder

D49.7 Neoplasm of unspecified behavior of endocrine 

glands

Remainder Remainder Remainder Remainder Remainder

D49.81 Neoplasm of unspecified behavior of retina and 

choroid

Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

D49.89 Neoplasm of unspecified behavior of other 

specified sites

Remainder Remainder Remainder Remainder Remainder

D49.9 Neoplasm of unspecified behavior of unspecified 

site

Remainder Remainder Remainder Remainder Remainder
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ICD-10

code Cancer code explanation PFG and chest Lumbar spine

Thoracic 

spine Cervical spine Pelvis

D68 Activated protein C resistance, Prothrombin, 

Thrombophilia, Antiphosholipid syndrome, Lupus

Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D74 Methemoglobinemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D75 Myelofibrosis, Disease of blood and bloodforming organsBone marrow Bone marrow Bone marrow Bone marrow Bone marrow

D89.2 Hypergammaglobulinemia, unspecified Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

E31.22 Multiple endocrine neoplasia [MEN] type IIA Remainder Remainder Remainder Remainder Remainder

J91.0 Malignant pleural effusion Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea

Q85.00 Neurofibromatosis, unspecified Remainder Remainder Remainder Remainder Remainder

Q85.01 Neurofibromatosis, type 1 Remainder Remainder Remainder Remainder Remainder

Q85.02 Neurofibromatosis, type 2 Remainder Remainder Remainder Remainder Remainder

R18.0 Malignant ascites Likely sitea Likely sitea Likely sitea Likely sitea Likely sitea

a. For secondary cancers, doses are assessed for the likely primary cancer site(s), which are selected using guidance in Table 3-2 of ORAUT-OTIB-0005 (ORAUT 

2019). 
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Table A-2. Selection of organs for chest X-ray dose assignment through 1970 based on ICD-10 code when referred from Table A-1.a 

ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C00 Malignant neoplasm of lip Eye/brain Eye/brain Eye/brain ENSD ENSD ENSD Eye/brain

C41.0 Malignant neoplasm of bones of skull and 

face

10% ENSD 10% ENSD Eye/brain 10% ENSD 10% ENSD 10% ENSD 10% ENSD

C43.0 Malignant melanoma of lip Eye/brain Eye/brain Eye/brain ENSD ENSD ENSD Eye/brain

C43.70 Malignant melanoma of unspecified lower 

limb, including hip

10% ENSD 10% ENSD 10% Lung 10% ENSD 10% ENSD 10% ENSD 10% ENSD

C44.0 Malignant neoplasm BCC, SCC of skin of 

lip

Eye/brain Eye/brain Eye/brain ENSD ENSD ENSD Eye/brain

C47.0 Malignant neoplasm of peripheral nerves 

of head, face and neck

10% ENSD ENSD ENSD ENSD ENSD ENSD ENSD

C49.0 Malignant neoplasm of connective and 

soft tissue of head, face and neck

10% ENSD ENSD ENSD ENSD ENSD ENSD ENSD

C4A.0 Merkel cell carcinoma of lip Eye/brain Eye/brain Eye/brain ENSD ENSD ENSD Eye/brain

C81.00 Nodular lymphocyte predominant 

Hodgkin lymphoma, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C81.04 Nodular lymphocyte predominant 

Hodgkin lymphoma, lymph nodes of axilla 

and upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.08 Nodular lymphocyte predominant 

Hodgkin lymphoma, lymph nodes of 

multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.09 Nodular lymphocyte predominant 

Hodgkin lymphoma, extranodal and solid 

organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.10 Nodular sclerosis Hodgkin lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C81.14 Nodular sclerosis Hodgkin lymphoma, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.18 Nodular sclerosis Hodgkin lymphoma, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.19 Nodular sclerosis Hodgkin lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.20 Mixed cellularity Hodgkin lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C81.24 Mixed cellularity Hodgkin lymphoma, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.28 Mixed cellularity Hodgkin lymphoma, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.29 Mixed cellularity Hodgkin lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.30 Lymphocyte depleted Hodgkin 

lymphoma, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C81.34 Lymphocyte depleted Hodgkin 

lymphoma, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.38 Lymphocyte depleted Hodgkin 

lymphoma, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.39 Lymphocyte depleted Hodgkin 

lymphoma, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.40 Lymphocyte-rich Hodgkin lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C81.44 Lymphocyte-rich Hodgkin lymphoma, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.48 Lymphocyte-rich Hodgkin lymphoma, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.49 Lymphocyte-rich Hodgkin lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.70 Other Hodgkin lymphoma, unspecified 

site

Lung Lung Lung Thyroid Lung Lung Lung

C81.74 Other Hodgkin lymphoma, lymph nodes 

of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C81.78 Other Hodgkin lymphoma, lymph nodes 

of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.79 Other Hodgkin lymphoma, extranodal and 

solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.90 Hodgkin lymphoma, unspecified, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C81.94 Hodgkin lymphoma, unspecified, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C81.98 Hodgkin lymphoma, unspecified, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C81.99 Hodgkin lymphoma, unspecified, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.00 Follicular lymphoma grade I, unspecified 

site

Lung Lung Lung Thyroid Lung Lung Lung

C82.04 Follicular lymphoma grade I, lymph nodes 

of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.08 Follicular lymphoma grade I, lymph nodes 

of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.09 Follicular lymphoma grade I, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.10 Follicular lymphoma grade II, unspecified 

site

Lung Lung Lung Thyroid Lung Lung Lung

C82.14 Follicular lymphoma grade II, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.18 Follicular lymphoma grade II, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.19 Follicular lymphoma grade II, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.20 Follicular lymphoma grade III, 

unspecified, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.24 Follicular lymphoma grade III, 

unspecified, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.28 Follicular lymphoma grade III, 

unspecified, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.29 Follicular lymphoma grade III, 

unspecified, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.30 Follicular lymphoma grade IIIa, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.34 Follicular lymphoma grade IIIa, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.38 Follicular lymphoma grade IIIa, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C82.39 Follicular lymphoma grade IIIa, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.40 Follicular lymphoma grade IIIb, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.44 Follicular lymphoma grade IIIb, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.48 Follicular lymphoma grade IIIb, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.49 Follicular lymphoma grade IIIb, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.50 Diffuse follicle center lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.54 Diffuse follicle center lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.58 Diffuse follicle center lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.59 Diffuse follicle center lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.60 Cutaneous follicle center lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.64 Cutaneous follicle center lymphoma, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.68 Cutaneous follicle center lymphoma, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.69 Cutaneous follicle center lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.80 Other types of follicular lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C82.84 Other types of follicular lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.88 Other types of follicular lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.89 Other types of follicular lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.90 Follicular lymphoma, unspecified, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C82.94 Follicular lymphoma, unspecified, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C82.98 Follicular lymphoma, unspecified, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C82.99 Follicular lymphoma, unspecified, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.00 Small cell B-cell lymphoma, unspecified 

site

Lung Lung Lung Thyroid Lung Lung Lung

C83.04 Small cell B-cell lymphoma, lymph nodes 

of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.08 Small cell B-cell lymphoma, lymph nodes 

of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.09 Small cell B-cell lymphoma, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.10 Mantle cell lymphoma, unspecified site Lung Lung Lung Thyroid Lung Lung Lung

C83.14 Mantle cell lymphoma, lymph nodes of 

axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.18 Mantle cell lymphoma, lymph nodes of 

multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.19 Mantle cell lymphoma, extranodal and 

solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.30 Diffuse large B-cell lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C83.34 Diffuse large B-cell lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.38 Diffuse large B-cell lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.39 Diffuse large B-cell lymphoma, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.50 Lymphoblastic (diffuse) lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C83.54 Lymphoblastic (diffuse) lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.58 Lymphoblastic (diffuse) lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C83.59 Lymphoblastic (diffuse) lymphoma, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.70 Burkitt lymphoma, unspecified site Breast Lung Breast Breast Breast Breast Lung

C83.74 Burkitt lymphoma, lymph nodes of axilla 

and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.78 Burkitt lymphoma, lymph nodes of 

multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.79 Burkitt lymphoma, extranodal and solid 

organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.80 Other non-follicular lymphoma, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C83.84 Other non-follicular lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.88 Other non-follicular lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.89 Other non-follicular lymphoma, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.90 Non-follicular (diffuse) lymphoma, 

unspecified, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C83.94 Non-follicular (diffuse) lymphoma, 

unspecified, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C83.98 Non-follicular (diffuse) lymphoma, 

unspecified, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C83.99 Non-follicular (diffuse) lymphoma, 

unspecified, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.00 Mycosis fungoides, unspecified site Lung Lung Lung Thyroid Lung Lung Lung

C84.04 Mycosis fungoides, lymph nodes of axilla 

and upper limb

Breast Lung Lung Breast Breast Breast Lung

C84.08 Mycosis fungoides, lymph nodes of 

multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.09 Mycosis fungoides, extranodal and solid 

organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.10 Sezary disease, unspecified site Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C84.14 Sezary disease, lymph nodes of axilla 

and upper limb

Breast Lung Lung Breast Breast Breast Lung

C84.18 Sezary disease, lymph nodes of multiple 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.19 Sezary disease, extranodal and solid 

organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.40 Peripheral T-cell lymphoma, not 

classified, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C84.44 Peripheral T-cell lymphoma, not 

classified, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C84.48 Peripheral T-cell lymphoma, not 

classified, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.49 Peripheral T-cell lymphoma, not 

classified, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.60 Anaplastic large cell lymphoma, ALKpositive, unspecified siteLung Lung Lung Thyroid Lung Lung Lung

C84.64 Anaplastic large cell lymphoma, ALKpositive, lymph nodes of axilla and upper 

limb

Breast Lung Lung Breast Breast Breast Lung

C84.68 Anaplastic large cell lymphoma, ALKpositive, lymph nodes of multiple sitesLung Lung Lung Thyroid Lung Lung Lung

C84.69 Anaplastic large cell lymphoma, ALKpositive, extranodal and solid organ sitesLung Lung Lung Thyroid Lung Lung Lung

C84.70 Anaplastic large cell lymphoma, ALKnegative, unspecified siteLung Lung Lung Thyroid Lung Lung Lung

C84.74 Anaplastic large cell lymphoma, ALKnegative, lymph nodes of axilla and upper 

limb

Breast Lung Lung Breast Breast Breast Lung

C84.78 Anaplastic large cell lymphoma, ALKnegative, lymph nodes of multiple sitesLung Lung Lung Thyroid Lung Lung Lung

C84.79 Anaplastic large cell lymphoma, ALKnegative, extranodal and solid organ sitesLung Lung Lung Thyroid Lung Lung Lung

C84.90 Mature T/NK-cell lymphomas, 

unspecified, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C84.94 Mature T/NK-cell lymphomas, 

unspecified, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C84.98 Mature T/NK-cell lymphomas, 

unspecified, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.99 Mature T/NK-cell lymphomas, 

unspecified, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.Z0 Other mature T/NK-cell lymphomas, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C84.Z4 Other mature T/NK-cell lymphomas, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C84.Z8 Other mature T/NK-cell lymphomas, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C84.Z9 Other mature T/NK-cell lymphomas, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.10 Unspecified B-cell lymphoma, unspecified 

site

Lung Lung Lung Thyroid Lung Lung Lung

C85.14 Unspecified B-cell lymphoma, lymph 

nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C85.18 Unspecified B-cell lymphoma, lymph 

nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.19 Unspecified B-cell lymphoma, extranodal 

and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.20 Mediastinal (thymic) large B-cell 

lymphoma, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C85.24 Mediastinal (thymic) large B-cell 

lymphoma, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C85.28 Mediastinal (thymic) large B-cell 

lymphoma, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.29 Mediastinal (thymic) large B-cell 

lymphoma, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.80 Other specified types of non-Hodgkin 

lymphoma, unspecified site

Lung Lung Lung Thyroid Lung Lung Lung
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ICD-10 

code Cancer code explanation PFG

PA

chest

LAT 

chest

AP lordotic 

chest

RAO 

chest

LAO

chest

Chest 

fluoroscopy

C85.84 Other specified types of non-Hodgkin 

lymphoma, lymph nodes of axilla and 

upper limb

Breast Lung Lung Breast Breast Breast Lung

C85.88 Other specified types of non-Hodgkin

lymphoma, lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.89 Other specified types of non-Hodgkin 

lymphoma, extranodal and solid organ 

sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.90 Non-Hodgkin lymphoma, unspecified, 

unspecified site

Lung Lung Lung Thyroid Lung Lung Lung

C85.94 Non-Hodgkin lymphoma, unspecified, 

lymph nodes of axilla and upper limb

Breast Lung Lung Breast Breast Breast Lung

C85.98 Non-Hodgkin lymphoma, unspecified, 

lymph nodes of multiple sites

Lung Lung Lung Thyroid Lung Lung Lung

C85.99 Non-Hodgkin lymphoma, unspecified, 

extranodal and solid organ sites

Lung Lung Lung Thyroid Lung Lung Lung

C96.20 Malignant mast cell neoplasm, 

unspecified

Lung Lung Lung Thyroid Lung Lung Lung

C96.20 Malignant mast cell neoplasm, axilla Breast Lung Lung Breast Breast Breast Lung

C96.20 Malignant mast cell neoplasm, multiple Lung Lung Lung Thyroid Lung Lung Lung

C96.21 Aggressive systemic mastocytosis, 

unspecified

Lung Lung Lung Thyroid Lung Lung Lung

C96.21 Aggressive systemic mastocytosis, axilla Breast Lung Lung Breast Breast Breast Lung

C96.21 Aggressive systemic mastocytosis, 

multiple

Lung Lung Lung Thyroid Lung Lung Lung

C96.22 Mast cell sarcoma, unspecified Lung Lung Lung Thyroid Lung Lung Lung

C96.22 Mast cell sarcoma, axilla Breast Lung Lung Breast Breast Breast Lung

C96.22 Mast cell sarcoma, multiple Lung Lung Lung Thyroid Lung Lung Lung

C96.29 Other malignant mast cell neoplasm, 

unspecified

Lung Lung Lung Thyroid Lung Lung Lung

C96.29 Other malignant mast cell neoplasm, 

axilla

Breast Lung Lung Breast Breast Breast Lung

D0.30 Melanoma in situ of lip Eye/Brain Eye/Brain Eye/Brain ENSD ENSD ENSD Eye/Brain

D0.40 Carcinoma in situ of skin of lip Eye/Brain Eye/Brain Eye/Brain ENSD ENSD ENSD Eye/Brain

D37.01 Neoplasm of uncertain behavior of lip Eye/Brain Eye/Brain Eye/Brain ENSD ENSD ENSD Eye/Brain

a. X-ray organs based guidance provide in OCAS TIB-0012 and selecting organ in OCAS-TIB-0012 grouping that provides highest dose (NIOSH 2006). 
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Table A-3 Selection of organs for chest X-ray dose assignment after 1970 based on ICD-10 code when referred from Table A-1. 

ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C00 Malignant neoplasm of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

C41.0 Malignant neoplasm of bones of skull and face 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD

C43.0 Malignant melanoma of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

C43.70 Malignant melanoma of unspecified lower limb, 

including hip

10% ENSD 10% Lung 10% ENSD 10% ENSD 10% ENSD

C44.0 Malignant neoplasm, BCC, SCC of skin of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

C47.0 Malignant neoplasm of peripheral nerves of head, 

face and neck

10% ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

C49.0 Malignant neoplasm of connective and soft tissue 

of head, face and neck

10% ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

C4A.0 Merkel cell carcinoma of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

C81.00 Nodular lymphocyte predominant Hodgkin 

lymphoma, unspecified site

Lung Lung Thyroid Lung Lung

C81.04 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of axilla and upper limb

Breast Breast Breast Breast Breast

C81.08 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of multiple sites

Lung Lung Thyroid Lung Lung

C81.09 Nodular lymphocyte predominant Hodgkin 

lymphoma, extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C81.10 Nodular sclerosis Hodgkin lymphoma, unspecified 

site

Lung Lung Thyroid Lung Lung

C81.14 Nodular sclerosis Hodgkin lymphoma, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C81.18 Nodular sclerosis Hodgkin lymphoma, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C81.19 Nodular sclerosis Hodgkin lymphoma, extranodal 

and solid organ sites

Lung Lung Thyroid Lung Lung

C81.20 Mixed cellularity Hodgkin lymphoma, unspecified 

site

Lung Lung Thyroid Lung Lung

C81.24 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C81.28 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C81.29 Mixed cellularity Hodgkin lymphoma, extranodal 

and solid organ sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C81.30 Lymphocyte depleted Hodgkin lymphoma, 

unspecified site

Lung Lung Thyroid Lung Lung

C81.34 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C81.38 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of multiple sites

Lung Lung Thyroid Lung Lung

C81.39 Lymphocyte depleted Hodgkin lymphoma, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C81.40 Lymphocyte-rich Hodgkin lymphoma, unspecified 

site

Lung Lung Thyroid Lung Lung

C81.44 Lymphocyte-rich Hodgkin lymphoma, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C81.48 Lymphocyte-rich Hodgkin lymphoma, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C81.49 Lymphocyte-rich Hodgkin lymphoma, extranodal 

and solid organ sites

Lung Lung Thyroid Lung Lung

C81.70 Other Hodgkin lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C81.74 Other Hodgkin lymphoma, lymph nodes of axilla 

and upper limb

Lung Breast Breast Breast Breast

C81.78 Other Hodgkin lymphoma, lymph nodes of multiple 

sites

Lung Lung Thyroid Lung Lung

C81.79 Other Hodgkin lymphoma, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C81.90 Hodgkin lymphoma, unspecified, unspecified site Lung Lung Thyroid Lung Lung

C81.94 Hodgkin lymphoma, unspecified, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C81.98 Hodgkin lymphoma, unspecified, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C81.99 Hodgkin lymphoma, unspecified, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C82.00 Follicular lymphoma grade I, unspecified site Lung Lung Thyroid Lung Lung

C82.04 Follicular lymphoma grade I, lymph nodes of axilla 

and upper limb

Lung Breast Breast Breast Breast

C82.08 Follicular lymphoma grade I, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C82.09 Follicular lymphoma grade I, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C82.10 Follicular lymphoma grade II, unspecified site Lung Lung Thyroid Lung Lung

C82.14 Follicular lymphoma grade II, lymph nodes of axilla 

and upper limb

Lung Breast Breast Breast Breast

C82.18 Follicular lymphoma grade II, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C82.19 Follicular lymphoma grade II, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C82.20 Follicular lymphoma grade III, unspecified, 

unspecified site

Lung Lung Thyroid Lung Lung

C82.24 Follicular lymphoma grade III, unspecified, lymph 

nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C82.28 Follicular lymphoma grade III, unspecified, lymph 

nodes of multiple sites

Lung Lung Thyroid Lung Lung

C82.29 Follicular lymphoma grade III, unspecified, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C82.30 Follicular lymphoma grade IIIa, unspecified site Lung Lung Thyroid Lung Lung

C82.34 Follicular lymphoma grade IIIa, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C82.38 Follicular lymphoma grade IIIa, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C82.39 Follicular lymphoma grade IIIa, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C82.40 Follicular lymphoma grade IIIb, unspecified site Lung Lung Thyroid Lung Lung

C82.44 Follicular lymphoma grade IIIb, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C82.48 Follicular lymphoma grade IIIb, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C82.49 Follicular lymphoma grade IIIb, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C82.50 Diffuse follicle center lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C82.54 Diffuse follicle center lymphoma, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C82.58 Diffuse follicle center lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C82.59 Diffuse follicle center lymphoma, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C82.60 Cutaneous follicle center lymphoma, unspecified 

site

Lung Lung Thyroid Lung Lung

C82.64 Cutaneous follicle center lymphoma, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C82.68 Cutaneous follicle center lymphoma, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C82.69 Cutaneous follicle center lymphoma, extranodal 

and solid organ sites

Lung Lung Thyroid Lung Lung

C82.80 Other types of follicular lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C82.84 Other types of follicular lymphoma, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C82.88 Other types of follicular lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C82.89 Other types of follicular lymphoma, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C82.90 Follicular lymphoma, unspecified, unspecified site Lung Lung Thyroid Lung Lung

C82.94 Follicular lymphoma, unspecified, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C82.98 Follicular lymphoma, unspecified, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C82.99 Follicular lymphoma, unspecified, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C83.00 Small cell B-cell lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C83.04 Small cell B-cell lymphoma, lymph nodes of axilla 

and upper limb

Lung Breast Breast Breast Breast

C83.08 Small cell B-cell lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C83.09 Small cell B-cell lymphoma, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C83.10 Mantle cell lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C83.14 Mantle cell lymphoma, lymph nodes of axilla and 

upper limb

Lung Breast Breast Breast Breast

C83.18 Mantle cell lymphoma, lymph nodes of multiple 

sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C83.19 Mantle cell lymphoma, extranodal and solid organ 

sites

Lung Lung Thyroid Lung Lung

C83.30 Diffuse large B-cell lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C83.34 Diffuse large B-cell lymphoma, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C83.38 Diffuse large B-cell lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C83.39 Diffuse large B-cell lymphoma, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C83.50 Lymphoblastic (diffuse) lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C83.54 Lymphoblastic (diffuse) lymphoma, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C83.58 Lymphoblastic (diffuse) lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C83.59 Lymphoblastic (diffuse) lymphoma, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C83.70 Burkitt lymphoma, unspecified site Lung Breast Breast Breast Breast

C83.74 Burkitt lymphoma, lymph nodes of axilla and upper 

limb

Lung Breast Breast Breast Breast

C83.78 Burkitt lymphoma, lymph nodes of multiple sites Lung Lung Thyroid Lung Lung

C83.79 Burkitt lymphoma, extranodal and solid organ sites Lung Lung Thyroid Lung Lung

C83.80 Other non-follicular lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C83.84 Other non-follicular lymphoma, lymph nodes of 

axilla and upper limb

Lung Breast Breast Breast Breast

C83.88 Other non-follicular lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C83.89 Other non-follicular lymphoma, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C83.90 Non-follicular (diffuse) lymphoma, unspecified, 

unspecified site

Lung Lung Thyroid Lung Lung

C83.94 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C83.98 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of multiple sites

Lung Lung Thyroid Lung Lung

C83.99 Non-follicular (diffuse) lymphoma, unspecified, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C84.00 Mycosis fungoides, unspecified site Lung Lung Thyroid Lung Lung

C84.04 Mycosis fungoides, lymph nodes of axilla and upper 

limb

Lung Breast Breast Breast Breast

C84.08 Mycosis fungoides, lymph nodes of multiple sites Lung Lung Thyroid Lung Lung

C84.09 Mycosis fungoides, extranodal and solid organ sites Lung Lung Thyroid Lung Lung

C84.10 Sezary disease, unspecified site Lung Lung Thyroid Lung Lung

C84.14 Sezary disease, lymph nodes of axilla and upper 

limb

Lung Breast Breast Breast Breast

C84.18 Sezary disease, lymph nodes of multiple sites Lung Lung Thyroid Lung Lung

C84.19 Sezary disease, extranodal and solid organ sites Lung Lung Thyroid Lung Lung

C84.40 Peripheral T-cell lymphoma, not classified, 

unspecified site

Lung Lung Thyroid Lung Lung

C84.44 Peripheral T-cell lymphoma, not classified, lymph 

nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C84.48 Peripheral T-cell lymphoma, not classified, lymph 

nodes of multiple sites

Lung Lung Thyroid Lung Lung

C84.49 Peripheral T-cell lymphoma, not classified, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C84.60 Anaplastic large cell lymphoma, ALK-positive, 

unspecified site

Lung Lung Thyroid Lung Lung

C84.64 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C84.68 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of multiple sites

Lung Lung Thyroid Lung Lung

C84.69 Anaplastic large cell lymphoma, ALK-positive, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C84.70 Anaplastic large cell lymphoma, ALK-negative, 

unspecified site

Lung Lung Thyroid Lung Lung

C84.74 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C84.78 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of multiple sites

Lung Lung Thyroid Lung Lung

C84.79 Anaplastic large cell lymphoma, ALK-negative, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C84.90 Mature T/NK-cell lymphomas, unspecified, 

unspecified site

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C84.94 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C84.98 Mature T/NK-cell lymphomas, unspecified, lymph 

nodes of multiple sites

Lung Lung Thyroid Lung Lung

C84.99 Mature T/NK-cell lymphomas, unspecified, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C84.Z0 Other mature T/NK-cell lymphomas, unspecified 

site

Lung Lung Thyroid Lung Lung

C84.Z4 Other mature T/NK-cell lymphomas, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C84.Z8 Other mature T/NK-cell lymphomas, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C84.Z9 Other mature T/NK-cell lymphomas, extranodal and 

solid organ sites

Lung Lung Thyroid Lung Lung

C85.10 Unspecified B-cell lymphoma, unspecified site Lung Lung Thyroid Lung Lung

C85.14 Unspecified B-cell lymphoma, lymph nodes of axilla 

and upper limb

Lung Breast Breast Breast Breast

C85.18 Unspecified B-cell lymphoma, lymph nodes of 

multiple sites

Lung Lung Thyroid Lung Lung

C85.19 Unspecified B-cell lymphoma, extranodal and solid 

organ sites

Lung Lung Thyroid Lung Lung

C85.20 Mediastinal (thymic) large B-cell lymphoma, 

unspecified site

Lung Lung Thyroid Lung Lung

C85.24 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C85.28 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of multiple sites

Lung Lung Thyroid Lung Lung

C85.29 Mediastinal (thymic) large B-cell lymphoma, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C85.80 Other specified types of non-Hodgkin lymphoma, 

unspecified site

Lung Lung Thyroid Lung Lung

C85.84 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of axilla and upper limb

Lung Breast Breast Breast Breast

C85.88 Other specified types of non-Hodgkin lymphoma, 

lymph nodes of multiple sites

Lung Lung Thyroid Lung Lung
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ICD-10 code Cancer code explanation

PA

chest LAT chest

AP lordotic 

chest RAO chest

LAO

chest 

C85.89 Other specified types of non-Hodgkin lymphoma, 

extranodal and solid organ sites

Lung Lung Thyroid Lung Lung

C85.90 Non-Hodgkin lymphoma, unspecified, unspecified 

site

Lung Lung Thyroid Lung Lung

C85.94 Non-Hodgkin lymphoma, unspecified, lymph nodes 

of axilla and upper limb

Lung Breast Breast Breast Breast

C85.98 Non-Hodgkin lymphoma, unspecified, lymph nodes 

of multiple sites

Lung Lung Thyroid Lung Lung

C85.99 Non-Hodgkin lymphoma, unspecified, extranodal 

and solid organ sites

Lung Lung Thyroid Lung Lung

C96.20 Malignant mast cell neoplasm, unspecified Lung Lung Thyroid Lung Lung

C96.20 Malignant mast cell neoplasm, axilla Lung Breast Breast Breast Breast

C96.20 Malignant mast cell neoplasm, multiple Lung Lung Thyroid Lung Lung

C96.21 Aggressive systemic mastocytosis, unspecified Lung Lung Thyroid Lung Lung

C96.21 Aggressive systemic mastocytosis, axilla Lung Breast Breast Breast Breast

C9621 Aggressive systemic mastocytosis, multiple Lung Lung Thyroid Lung Lung

C96.22 Mast cell sarcoma, unspecified Lung Lung Thyroid Lung Lung

C96.22 Mast cell sarcoma, axilla Lung Breast Breast Breast Breast

C96.22 Mast cell sarcoma, multiple Lung Lung Thyroid Lung Lung

C96.29 Other malignant mast cell neoplasm, unspecified Lung Lung Thyroid Lung Lung

C96.29 Other malignant mast cell neoplasm, axilla Lung Breast Breast Breast Breast

D0.30 Melanoma in situ of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

D0.40 Carcinoma in situ of skin of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD

D37.01 Neoplasm of uncertain behavior of lip Eye/brain Eye/brain ENSD 10% ENSD 10% ENSD
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Table A-4. Selection of organs for lumbar spine X-ray dose assignment based on ICD-10 code when referred from Table A-1 . 

ICD-10

code Cancer code explanation

AP

lumbar spine

through 1970

AP

lumbar spine

after 1970

LAT

lumbar spine

through 1970

LAT

lumbar spine

after 1970

C40.1 Malignant neoplasm of short bones of upper limb ENSD 10% ENSD 10% ENSD 10% ENSD

C40.8 Malignant neoplasm of overlapping sites of bone and 

articular cartilage of limb

ENSD 10% ENSD 10% ENSD 10% ENSD

C40.9 Malignant neoplasm of unspecified bones and articular 

cartilage of limb

ENSD 10% ENSD 10% ENSD 10% ENSD
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Table A-5. Selection of organs for thoracic spine X-ray dose assignment based on ICD-10 code when referred from Table A-1. 

ICD-10

code Cancer code explanation

AP

thoracic spine

LAT

thoracic spine

RPO

thoracic spine

LPO

thoracic spine

C00.0 Malignant neoplasm of external upper lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.1 Malignant neoplasm of external lower lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.2 Malignant neoplasm of external lip, unspecified 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.3 Malignant neoplasm of upper lip, inner aspect 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.4 Malignant neoplasm of lower lip, inner aspect 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.5 Malignant neoplasm of lip, unspecified, inner aspect 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.6 Malignant neoplasm of commissure of lip, unspecified 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.8 Malignant neoplasm of overlapping sites of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C00.9 Malignant neoplasm of lip, unspecified 10% ENSD Eye/brain 10% ENSD 10% ENSD

C41.0 Malignant neoplasm of bones of skull and face 10% ENSD Eye/brain 10% ENSD 10% ENSD

C43.0 Malignant melanoma of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C44.00 Unspecified malignant neoplasm of skin of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C44.01 Basal cell carcinoma of skin of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C44.02 Squamous cell carcinoma of skin of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C44.09 Other specified malignant neoplasm of skin of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

C47.0 Malignant neoplasm of peripheral nerves of head, face and neck ENSD 10% ENSD ENSD ENSD

C47.3 Malignant neoplasm of peripheral nerves of thorax ENSD Lung ENSD ENSD

C47.4 Malignant neoplasm of peripheral nerves of abdomen ENSD Lung ENSD ENSD

C47.6 Malignant neoplasm of peripheral nerves of trunk, unspecified ENSD Lung ENSD ENSD

C47.8 Malignant neoplasm of overlapping sites of peripheral nerves and 

autonomic nervous system

ENSD Lung ENSD ENSD

C47.9 Malignant neoplasm of peripheral nerves and autonomic nervous 

system, unspecified

ENSD Lung ENSD ENSD

C49.0 Malignant neoplasm of connective and soft tissue of head, face and 

neck

ENSD 10% ENSD ENSD ENSD

C49.3 Malignant neoplasm of connective and soft tissue of thorax ENSD Lung ENSD ENSD

C49.4 Malignant neoplasm of connective and soft tissue of abdomen ENSD Lung ENSD ENSD

C49.6 Malignant neoplasm of connective and soft tissue of trunk, 

unspecified

ENSD Lung ENSD ENSD

C49.8 Malignant neoplasm of overlapping sites of connective and soft 

tissue

ENSD Lung ENSD ENSD

C49.9 Malignant neoplasm of connective and soft tissue, unspecified ENSD Lung ENSD ENSD

C4A.0 Merkel cell carcinoma of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

D03.0 Melanoma in situ of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD

D04.0 Carcinoma in situ of skin of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD
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ICD-10

code Cancer code explanation

AP

thoracic spine

LAT

thoracic spine

RPO

thoracic spine

LPO

thoracic spine

D37.01 Neoplasm of uncertain behavior of lip 10% ENSD Eye/brain 10% ENSD 10% ENSD
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Table A-6. Selection of organs for cervical spine X-ray dose reconstruction based on ICD-10 code when different organ selection is 

required based on view.

ICD-10

code Cancer code explanation

AP

cervical spine

LAT

cervical spine

RPO

cervical spine 

LPO

cervical spine 

C40.00 Malignant neoplasm of scapula and long bones of 

unspecified upper limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.01 Malignant neoplasm of scapula and long bones of right 

upper limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.02 Malignant neoplasm of scapula and long bones of left 

upper limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.80 Malignant neoplasm of overlapping sites of bone and 

articular cartilage of unspecified limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.81 Malignant neoplasm of overlapping sites of bone and 

articular cartilage of right limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.82 Malignant neoplasm of overlapping sites of bone and 

articular cartilage of left limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.90 Malignant neoplasm of unspecified bones and articular 

cartilage of unspecified limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.91 Malignant neoplasm of unspecified bones and articular 

cartilage of right limb

10% ENSD ENSD 10% ENSD 10% ENSD

C40.92 Malignant neoplasm of unspecified bones and articular 

cartilage of left limb

10% ENSD ENSD 10% ENSD 10% ENSD

C47.10 Malignant neoplasm of peripheral nerves of unspecified 

upper limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD

C47.11 Malignant neoplasm of peripheral nerves of right upper 

limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD

C47.12 Malignant neoplasm of peripheral nerves of left upper 

limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD

C47.3 Malignant neoplasm of peripheral nerves of thorax ENSD 10% ENSD ENSD ENSD

C47.6 Malignant neoplasm of peripheral nerves of trunk, 

unspecified

ENSD 10% ENSD ENSD ENSD

C47.8 Malignant neoplasm of overlapping sites of peripheral 

nerves and autonomic nervous system

ENSD 10% ENSD ENSD ENSD

C47.9 Malignant neoplasm of peripheral nerves and autonomic 

nervous system, unspecified

ENSD 10% ENSD ENSD ENSD

C49.10 Malignant neoplasm of connective and soft tissue of 

unspecified upper limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD
ATTACHMENT A

SELECTION OF ORGAN BASED ON ICD-10 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

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ICD-10

code Cancer code explanation

AP

cervical spine

LAT

cervical spine

RPO

cervical spine 

LPO

cervical spine 

C49.11 Malignant neoplasm of connective and soft tissue of right 

upper limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD

C49.12 Malignant neoplasm of connective and soft tissue of left 

upper limb, including shoulder

10% ENSD ENSD 10% ENSD 10% ENSD

C49.3 Malignant neoplasm of connective and soft tissue of

thorax

ENSD 10% ENSD ENSD ENSD

C49.6 Malignant neoplasm of connective and soft tissue of 

trunk, unspecified

ENSD 10% ENSD ENSD ENSD

C49.8 Malignant neoplasm of overlapping sites of connective 

and soft tissue

ENSD 10% ENSD ENSD ENSD

C49.9 Malignant neoplasm of connective and soft tissue, 

unspecified

ENSD 10% ENSD ENSD ENSD
Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 109 of 140

 

ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES

LIST OF TABLES

TABLE TITLE PAGE

B-1 DCFs used in determining dose equivalents from thoracic and cervical spine projections 

through 1970........................................................................................................................ 110

B-2 DCFs used in determining dose equivalents for chest projections through 1985 .................. 111

B-3 DCFs used in determining dose equivalents for chest projections 1986 and later, and for 

lumbar spine and pelvis for all periods ................................................................................. 112

B-4 Skin dose guidance for chest projections for the poor collimation period through 1970........ 113

B-5 Skin dose guidance for lumbar spine and pelvis projections for the poor collimation 

period through 1970............................................................................................................. 115

B-6 Skin dose guidance for thoracic spine projections for the poor collimation period through 

1970..................................................................................................................................... 117

B-7 Skin dose guidance for cervical spine projections for the poor collimation period through 

1970..................................................................................................................................... 119

B-8 Skin dose guidance for chest projections for the good collimation period after 1970 ............ 121

B-9 Skin dose guidance for lumbar spine projections for the good collimation period after 

1970..................................................................................................................................... 123

B-10 Organ dose equivalents for chest projections for all periods................................................. 125

B-11 Skin dose equivalents from chest projections through 1970................................................. 128

B-12 Skin dose equivalents from various chest projections after 1970.......................................... 130

B-13 Organ dose equivalents for lumbar spine and pelvis projections for all periods .................... 132

B-14 Skin dose equivalent from lumbar spine and pelvis projections for all periods...................... 134

B-15 Organ dose equivalents for thoracic and cervical spine projections through 1970................ 136

B-16 Skin dose equivalent from thoracic and cervical spine projections through 1970.................. 139
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-1. DCFs used in determining dose equivalents from thoracic and cervical spine projections through 1970 (rem/cGy)

a

. 

Organ

AP

thoracic spine

LAT/OBL

thoracic spine

AP/OBL

cervical spine 

LAT

cervical spine 

Thyroid 9.40E−02 5.60E−02 7.53E−01 5.60E−02

Eye/brain 9.40E−03 4.00E−03 7.53E−01 5.60E−02

Ovaries Measuredb Measuredb Measuredb Measuredb

Liver/gallbladder/spleen 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Urinary bladder/prostate Measuredb Measuredb Measuredb Measuredb

Colon rectum Measuredb Measuredb Measuredb Measuredb

Testes Measuredb Measuredb Measuredb Measuredb

Lungs male 3.32E−01 1.07E−01 1.50E−02 2.30E−02

Lungs female 2.37E−01 1.28E−01 1.50E−02 2.30E−02

Thymus 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Esophagus 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Stomach 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Bone surfaces 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Remainder 3.32E−01 1.28E−01 1.50E−02 2.30E−02

Breast 7.34E−01 5.60E−03 1.50E−02 2.30E−02

Uterus Measuredb Measuredb Measuredb Measuredb

Bone marrow male 2.90E−02 1.80E−02 1.10E−02 1.70E−02

Bone marrow female 2.30E−02 1.40E−02 1.10E−02 1.70E−02

a. HVL = 2.0 mm Al.

b. Measured means that a measured dose from literature is used rather than a DCF.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-2. DCFs used in determining dose equivalents for chest projections through 1985 (rem/cGy).

Organ

PFG

through 

1970a

Chest

fluoroscopy 

through 1970b

PA chest

through 1970a

LAT/OBL 

chest through 

1970a

AP lordotic 

chest through 

1970a

PA chest

1971–1985a

LAT/OBL 

chest

1971–1985a

AP lordotic 

chest

1971–1985a

Thyroid 1.74E−01c 1.50E−01c 1.74E−01c 1.37E−01 8.68E−01d 3.20E−02 1.15E−01 3.17E−01

Eye/brain 3.20E−02 2.10E−02 3.20E−02 1.15E−01 8.68E−01d 3.20E−02 1.15E−01 3.17E−01

Ovaries Measurede 6.00E−04 Measurede Measurede 2.33E−01 1.00E−03 6.00E−04 2.00E−03

Liver/ gallbladder/spleen 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Urinary bladder/prostate Measurede 6.00E−04 Measurede Measurede 2.33E−01 1.00E−03 6.00E−04 2.00E−03

Colon rectum Measurede 6.00E−04 Measurede Measurede 2.33E−01 1.00E−03 6.00E−04 2.00E−03

Testes Measurede 1.00E−05 Measurede Measurede 1.80E−02 1.00E−05 1.00E−04 1.00E−05

Lungs male 4.19E−01 3.35E−01 4.19E−01 1.93E−01 4.73E−01 4.19E−01 1.93E−01 4.73E−01

Lungs female 4.51E−01 3.55E−01 4.51E−01 2.20E−01 3.53E−01 4.51E−01 2.20E−01 3.53E−01

Thymus 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Esophagus 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Stomach 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Bone surfaces 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Remainder 4.51E−01 3.55E−01 4.51E−01 2.20E−01 4.73E−01 4.51E−01 2.20E−01 4.73E−01

Breast 4.90E−02 3.20E−02 4.90E−02 2.55E−01 8.36E−01 4.90E−02 2.55E−01 8.36E−01

Uterus Measurede 7.00E−04 Measurede Measurede 3.05E−01 1.30E−03 6.00E−04 1.50E−03

Bone marrow male 9.20E−02 6.90E−02 9.20E−02 3.70E−02 4.80E−02 9.20E−02 3.70E−02 4.80E−02

Bone marrow female 8.60E−02 6.30E−02 8.60E−02 2.90E−02 4.80E−02 8.60E−02 2.90E−02 4.80E−02

a. HVL = 2.5 mm Al.

b. HVL = 2.0 mm Al.

c. Dose Conversion Factor for AP cervical spine, corrected for depth by multiplying by 0.2

d. Cervical spine Thyroid DCF used to account for poor collimation.

e. Measured means that a measured dose from literature is used rather than a DCF.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-3. DCFs used in determining dose equivalents for chest projections 1986 and later, and for lumbar spine and pelvis for all periods 

(rem/cGy).

Organ

PA

chest

1986 and latera

LAT/OBL 

chest

1986 and latera

AP

lumbar spine 

through 1970b

LAT

lumbar spine 

through 1970b

AP

lumbar spine

1971−1985c

LAT

lumbar spine 

1971−1985c

AP

pelvis

through 1970b

Thyroid 7.80E−02 1.64E−01 2.00E−04 1.00E−05 3.00E−04 1.00E−05 1.00E−05

Eye/brain 7.80E−02 1.64E−01 2.00E−04 1.00E−05 3.00E−04 1.00E−05 1.00E−05

Ovaries 5.20E−03 2.50E−03 Measuredd Measuredd 2.16E−01 4.70E−02 Measuredd

Liver/gallbladder/spleen 6.74E−01 3.51E−01 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Urinary bladder/prostate 5.20E−03 2.50E−03 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Colon rectum 5.20E−03 2.50E−03 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Testes 1.00E−05 1.00E−04 Measuredd Measuredd 4.20E−03 8.00E−04 Measuredd

Lungs male 6.28E−01 3.13E−01 6.20E−02 1.00E−02 7.90E−02 1.40E−02 1.00E−03

Lungs female 6.74E−01 3.51E−01 6.20E−02 1.00E−02 7.90E−02 1.40E−02 1.00E−03

Thymus 6.74E−01 3.51E−01 6.20E−02 1.00E−02 7.90E−02 1.40E−02 1.00E−03

Esophagus 6.74E−01 3.51E−01 6.20E−02 1.00E−02 7.90E−02 1.40E−02 1.00E−03

Stomach 6.74E−01 3.51E−01 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Bone surfaces 6.74E−01 3.51E−01 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Remainder 6.74E−01 3.51E−01 Measurede Measurede 2.16E−01 4.70E−02 Measurede

Breast 1.16E−01 3.43E−01 6.20E−02 1.00E−02 7.90E−02 1.40E−02 1.00E−03

Uterus 5.20E−03 2.10E−03 Measuredd Measuredd 2.87E−01 3.10E−02 2.44E−01

Bone marrow male 1.78E−01 7.60E−02 2.40E−02 1.50E−02 3.70E−02 2.20E−02 2.30E−02

Bone marrow female 1.72E−01 5.90E−02 2.40E−02 1.50E−02 3.70E−02 2.20E−02 2.30E−02

a. HVL = 4.0 mm Al.

b. HVL = 2.0 mm Al.

c. HVL = 2.5 mm Al.

d. Measured means that a measured dose from literature is used rather than a DCF.

e. Measured means that this dose is assigned based on the measured ovary dose from literature.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-4. Skin dose guidance for chest projections for the poor collimation period through 1970. 

Area of skin

PFG

1943–1970

PA chest

through 

1970a

LAT chest

through 

1970

AP lordotic 

chest 

through 

1970

RAO chest

through 

1970

LAO chest

through 

1970

Chest 

fluoroscopy 

through 

1970a

R front shoulder EXSD EXSD ENSD ENSD EXSD EXSD EXSD

R back shoulder ENSD ENSD ENSD EXSD ENSD ENSD ENSD

L front shoulder EXSD EXSD EXSD ENSD EXSD EXSD EXSD

L back shoulder ENSD ENSD EXSD EXSD ENSD ENSD ENSD

R upper arm to elbow 10% ENSD ENSD ENSD ENSD ENSD ENSD ENSD

L upper arm to elbow 10% ENSD ENSD EXSD ENSD ENSD ENSD ENSD

L hand ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD ENSD

R hand ENSD ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD ENSD

L elbow, forearm, wrist 10% ENSD ENSD 10% ENSD ENSD 10% ENSD 10% ENSD ENSD

R elbow, forearm, wrist 10% ENSD ENSD 10% ENSD ENSD 10% ENSD 10% ENSD ENSD

R side of head (including temple and ear) 10% ENSD 10% ENSD Eye/brain 10% ENSD 10% EXSD 10% ENSD 10% ENSD

L side of head (including temple and ear) 10% ENSD 10% ENSD Eye/brain 10% ENSD 10% ENSD 10% EXSD 10% ENSD

Front L thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back L thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Front R thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back R thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

L knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

R knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

L side of face Eye/brain Eye/brain Eye/brain ENSD ENSD EXSD Eye/brain

R side of face Eye/brain Eye/brain Eye/brain ENSD EXSD ENSD Eye/brain

L side of neck 10% ENSD ENSD Eye/brain ENSD ENSD EXSD ENSD

R side of neck 10% ENSD ENSD Eye/brain ENSD EXSD ENSD ENSD

Back of head 10% ENSD 10% ENSD Eye/brain EXSD 10% ENSD 10% ENSD 10% ENSD

Front of neck Eye/brain Eye/brain Eye/brain ENSD Eye/brain Eye/brain Eye/brain

Back of neck 10% ENSD ENSD Eye/brain EXSD ENSD ENSD ENSD

Front torso: base of neck to end of 

sternum

EXSD EXSD Lungb ENSD EXSD EXSD EXSD

Front torso: end of sternum to lowest rib EXSD EXSD Lungb ENSD EXSD EXSD EXSD

Front torso: lowest rib to iliac crest EXSD EXSD Lungb ENSD EXSD EXSD EXSD

Front torso: iliac crest to pubis 10% EXSD 10% EXSD 10% Lungb 10% ENSD 10% EXSD 10% EXSD 10% EXSD

Back torso: base of neck to mid-back ENSD ENSD Lungb EXSD ENSD ENSD ENSD

Back torso: mid-back to lowest rib ENSD ENSD Lungb EXSD ENSD ENSD ENSD

Back torso: lowest rib to iliac crest ENSD ENSD Lungb EXSD ENSD ENSD ENSD
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

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Area of skin

PFG

1943–1970

PA chest

through 

1970a

LAT chest

through 

1970

AP lordotic 

chest 

through 

1970

RAO chest

through 

1970

LAO chest

through 

1970

Chest 

fluoroscopy 

through 

1970a

Back torso: buttocks (Iliac crest and 

below)

10% ENSD 10% ENSD 10% Lungb 10% EXSD 10% ENSD 10% ENSD 10% ENSD

Right torso: base of neck to end of 

sternum

ENSD ENSD ENSD ENSD EXSD ENSD ENSD

Right torso: end of sternum to lowest rib ENSD ENSD ENSD ENSD EXSD ENSD ENSD

Right torso: lowest rib to iliac crest ENSD ENSD ENSD ENSD EXSD ENSD ENSD

Right torso: iliac crest to pubis (R hip) 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD 10% ENSD

Left torso: base of neck to end of sternum ENSD ENSD EXSD ENSD ENSD EXSD ENSD

Left torso: end of sternum to lowest rib ENSD ENSD EXSD ENSD ENSD EXSD ENSD

Left torso: lowest rib to iliac crest ENSD ENSD EXSD ENSD ENSD EXSD ENSD

Left torso: iliac crest to pubis (L hip) 10% ENSD 10% ENSD 10% EXSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD

a. Skin dose guidance for chest fluoroscopy is the same as the guidance for the PA chest through 1970.

b. The higher of the male or female lung dose value should be used for both genders.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-5. Skin dose guidance for lumbar spine and pelvis projections for the poor collimation period through 1970. 

Area of skin

AP and AP spot

lumbar spine

through 1970 

LAT and LAT spot

lumbar spine

through 1970 

LPO

lumbar spine

through 1970 

RPO

lumbar spine

through 1970 

AP

pelvis

through 1970

R front shoulder 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD

R back shoulder 10% EXSD 10% ENSD 10% ENSD 10% EXSD 10% EXSD

L front shoulder 10% ENSD 10% EXSD 10% EXSD 10% ENSD 10% ENSD

L back shoulder 10% EXSD 10% EXSD 10% EXSD 10% EXSD 10% EXSD

R upper arm to elbow 10% ENSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD

L upper arm to elbow 10% ENSD 10% EXSD 10% EXSD 10% ENSD 10% ENSD

L hand ENSD 10% EXSD 10% EXSD 10% ENSD ENSD

R hand ENSD 10% ENSD 10% ENSD 10% EXSD ENSD

L elbow, forearm, wrist ENSD 10% EXSD 10% EXSD 10% ENSD ENSD

R elbow, forearm, wrist ENSD 10% ENSD 10% ENSD 10% EXSD ENSD

R side of head (including temple and ear) Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

L side of head (including temple and ear) Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

Front L thigh 10% ENSD 10% EXSD 10% ENSD 10% ENSD 10% ENSD

Back L thigh 10% EXSD 10% EXSD 10% EXSD 10% EXSD 10% EXSD

Front R thigh 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Back R thigh 10% EXSD 10% ENSD 10% EXSD 10% EXSD 10% EXSD

L knee and below RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m)

R knee and below RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m)

L side of face Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

R side of face Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

L side of neck Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

R side of neck Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

Back of head Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

Front of neck Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

Back of neck Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

Front torso: base of neck to end of sternum 10% ENSD Lunga 10% ENSD 10% ENSD 10% ENSD

Front torso: end of sternum to lowest rib ENSD Lunga ENSD ENSD ENSD

Front torso: lowest rib to iliac crest ENSD Lunga ENSD ENSD ENSD

Front torso: iliac crest to pubis ENSD Lunga ENSD ENSD ENSD

Back torso: base of neck to mid-back 10% EXSD Lunga 10% EXSD 10% EXSD 10% EXSD

Back torso: mid-back to lowest rib EXSD Lunga EXSD EXSD EXSD

Back torso: lowest rib to iliac crest EXSD Lunga EXSD EXSD EXSD

Back torso: buttocks (Iliac crest and below) EXSD Lunga EXSD EXSD EXSD

Right torso: base of neck to end of sternum 10% ENSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Area of skin

AP and AP spot

lumbar spine

through 1970 

LAT and LAT spot

lumbar spine

through 1970 

LPO

lumbar spine

through 1970 

RPO

lumbar spine

through 1970 

AP

pelvis

through 1970

Right torso: end of sternum to lowest rib ENSD ENSD ENSD EXSD ENSD

Right torso: lowest rib to iliac crest ENSD ENSD ENSD EXSD ENSD

Right torso: iliac crest to pubis (R hip) ENSD ENSD ENSD EXSD ENSD

Left torso: base of neck to end of sternum 10% ENSD 10% EXSD 10% EXSD 10% ENSD 10% ENSD

Left torso: end of sternum to lowest rib ENSD EXSD EXSD ENSD ENSD

Left torso: lowest rib to iliac crest ENSD EXSD EXSD ENSD ENSD

Left torso: iliac crest to pubis (L hip) ENSD EXSD EXSD ENSD ENSD

a. The higher of the male or female lung dose value should be used for both genders.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-6. Skin dose guidance for thoracic spine projections for the poor collimation period through 1970. 

Area of skin

AP thoracic spine

through 1970

LAT thoracic spine

through 1970

RPO thoracic spine

through 1970

LPO thoracic spine

through 1970

R front shoulder ENSD ENSD ENSD ENSD

R back shoulder EXSD ENSD EXSD EXSD

L front shoulder ENSD EXSD ENSD ENSD

L back shoulder EXSD EXSD EXSD EXSD

R upper arm to elbow ENSD ENSD ENSD ENSD

L upper arm to elbow ENSD EXSD ENSD ENSD

L hand 10% ENSD 10% ENSD 10% ENSD 10% ENSD

R hand 10% ENSD 10% ENSD 10% ENSD 10% ENSD

L elbow, forearm, wrist ENSD 10% ENSD 10% ENSD 10% ENSD

R elbow, forearm, wrist ENSD 10% ENSD 10% ENSD 10% ENSD

R Side of head (including temple and ear) 10% ENSD 10% ENSD 10% EXSD 10% ENSD

L Side of head (including temple and ear) 10% ENSD 10% ENSD 10% ENSD 10% EXSD

Front left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Front right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

L knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

R knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

L side of face 10% ENSD Eye/brain 10% ENSD 10% EXSD

R side of face 10% ENSD Eye/brain 10% EXSD 10% ENSD

L side of neck ENSD Eye/brain ENSD EXSD

R side of neck ENSD Eye/brain EXSD ENSD

Back of head 10% EXSD Eye/brain 10% ENSD 10% ENSD

Front of neck ENSD Eye/brain Thyroid Thyroid

Back of neck EXSD Eye/brain EXSD EXSD

Front torso: base of neck to end of sternum ENSD Lunga ENSD ENSD

Front torso: end of sternum to lowest rib ENSD Lunga ENSD ENSD

Front torso: lowest rib to iliac crest ENSD Lunga ENSD ENSD

Front torso: iliac crest to pubis 10% ENSD 10% lunga 10% ENSD 10% ENSD

Back torso: base of neck to mid-back EXSD Lunga EXSD EXSD

Back torso: mid-back to lowest rib EXSD Lunga EXSD EXSD

Back torso: lowest rib to iliac crest EXSD Lunga EXSD EXSD

Back torso: buttocks (Iliac crest and below) 10% EXSD 10% lunga 10% EXSD 10% EXSD

Right torso: base of neck to end of sternum ENSD ENSD EXSD ENSD

Right torso: end of sternum to lowest rib ENSD ENSD EXSD ENSD
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Area of skin

AP thoracic spine

through 1970

LAT thoracic spine

through 1970

RPO thoracic spine

through 1970

LPO thoracic spine

through 1970

Right torso: lowest rib to iliac crest ENSD ENSD EXSD ENSD

Right torso: iliac crest to pubis (R hip) 10% ENSD 10% ENSD 10% EXSD 10% ENSD

Left torso: base of neck to end of sternum ENSD EXSD ENSD EXSD

Left torso: end of sternum to lowest rib ENSD EXSD ENSD EXSD

Left torso: lowest rib to iliac crest ENSD EXSD ENSD EXSD

Left torso: iliac crest to pubis (L hip) 10% ENSD 10% EXSD 10% ENSD 10% EXSD

a. The higher of the male or female lung dose value should be used for both genders.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-7. Skin dose guidance for cervical spine projections for the poor collimation period through 1970. 

Area of skin

AP cervical spine

through 1970

LAT cervical spine

through 1970

RPO cervical spine

through 1970

LPO cervical spine

through 1970

R front shoulder 10% ENSD ENSD 10% ENSD 10% ENSD

R back shoulder 10% EXSD ENSD 10% EXSD 10% EXSD

L front shoulder 10% ENSD EXSD 10% ENSD 10% ENSD

L back shoulder 10% EXSD EXSD 10% EXSD 10% EXSD

R upper arm to elbow 10% ENSD 10% ENSD 10% EXSD 10% ENSD

L upper arm to elbow 10% ENSD 10% EXSD 10% ENSD 10% ENSD

L hand RSD (0.40 m) RSD (0.40 m) RSD (0.40 m) RSD (0.40 m)

R hand RSD (0.40 m) RSD (0.40 m) RSD (0.40 m) RSD (0.40 m)

L elbow, forearm, wrist RSD (0.40 m) RSD (0.40 m) RSD (0.40 m) RSD (0.40 m)

R elbow, forearm, wrist RSD (0.40 m) RSD (0.40 m) RSD (0.40 m) RSD (0.40 m)

R side of head (including temple and ear) ENSD ENSD EXSD2a ENSD

L side of head (including temple and ear) ENSD EXSD2a ENSD EXSD2a

Front left thigh RSD (0.70 m) RSD (0.70 m) RSD (0.70 m) RSD (0.70 m)

Back left thigh RSD (0.70 m) RSD (0.70 m) RSD (0.70 m) RSD (0.70 m)

Front right thigh RSD (0.70 m) RSD (0.70 m) RSD (0.70 m) RSD (0.70 m)

Back right thigh RSD (0.70 m) RSD (0.70 m) RSD (0.70 m) RSD (0.70 m)

L knee and below RSD (1.00 m) RSD (1.00 m) RSD (1.00 m) RSD (1.00 m)

R knee and below RSD (1.00 m) RSD (1.00 m) RSD (1.00 m) RSD (1.00 m)

L side of face ENSD EXSD2a ENSD EXSD2a

R side of face ENSD ENSD EXSD2a ENSD

L side of neck ENSD EXSD2a ENSD EXSD2a

R side of neck ENSD ENSD EXSD2a ENSD

Back of head EXSD ENSD ENSD ENSD

Front of neck ENSD ENSD ENSD ENSD

Back of neck EXSD2a EXSD2a EXSD2a EXSD2a

Front torso: base of neck to end of sternum ENSD 10% ENSD ENSD ENSD

Front torso: end of sternum to lowest rib RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Front torso: lowest rib to iliac crest RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Front torso: iliac crest to pubis RSD (0.50 m) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m)

Back torso: base of neck to mid-back EXSD 10% ENSD EXSD EXSD

Back torso: mid-back to lowest rib RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Back torso: lowest rib to iliac crest RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Back torso: buttocks (Iliac crest and below) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m)

Right torso: base of neck to end of sternum 10% ENSD ENSD 10% ENSD 10% ENSD

Right torso: end of sternum to lowest rib RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Area of skin

AP cervical spine

through 1970

LAT cervical spine

through 1970

RPO cervical spine

through 1970

LPO cervical spine

through 1970

Right torso: lowest Rib to iliac crest RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Right torso: iliac crest to pubis (R hip) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m)

Left torso: base of neck to end of sternum 10% ENSD EXSD 10% ENSD 10% ENSD

Left torso: end of sternum to lowest rib RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Left torso: lowest rib to iliac crest RSD (0.30 m) RSD (0.30 m) RSD (0.30 m) RSD (0.30 m)

Left torso: iliac crest to pubis (L hip) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m) RSD (0.50 m)

a. EXSD2 is the EXSD calculated at 15 cm (thickness of the neck) as opposed to 24 or 34 cm (the thickness of the chest).
ATTACHMENT B

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Table B-8. Skin dose guidance for chest projections for the good collimation period after 1970. 

Area of skin

PA chest

after 1970

LAT chest

after 1970

AP lordotic chest

after 1970

RAO chest

after 1970

LAO chest

after 1970

R front shoulder EXSD ENSD ENSD EXSD EXSD

R back shoulder ENSD ENSD EXSD ENSD ENSD

L front shoulder EXSD EXSD ENSD EXSD EXSD

L back shoulder ENSD EXSD EXSD ENSD ENSD

R upper arm to elbow 10% ENSD ENSD ENSD 10% ENSD 10% ENSD

L upper arm to elbow 10% ENSD EXSD ENSD 10% ENSD 10% ENSD

L hand 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD

R hand 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% ENSD

L elbow, forearm, wrist 10% ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

R elbow, forearm, wrist 10% ENSD 10% ENSD ENSD 10% ENSD 10% ENSD

R side of head (including temple and ear) 10% ENSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD

L side of head (including temple and ear) 10% ENSD 10% ENSD 10% ENSD 10% ENSD 10% EXSD

Front left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back left thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Front right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

Back right thigh RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m) RSD (0.52 m)

L knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

R knee and below RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m) RSD (0.86 m)

L side of face Eye/brain 10% ENSD ENSD 10% ENSD 10% EXSD

R side of face Eye/brain 10% ENSD ENSD 10% EXSD 10% ENSD

L side of neck 10% ENSD 10% ENSD ENSD 10% ENSD 10% EXSD

R side of neck 10% ENSD 10% ENSD ENSD 10% EXSD 10% ENSD

Back of head 10% ENSD 10% ENSD EXSD 10% ENSD 10% ENSD

Front of neck Thyroid 10% ENSD ENSD Thyroid Thyroid

Back of neck 10% ENSD 10% ENSD EXSD 10% ENSD 10% ENSD

Front torso: base of neck to end of sternum EXSD Lunga ENSD EXSD EXSD

Front torso: end of sternum to lowest rib EXSD Lunga ENSD EXSD EXSD

Front torso: lowest rib to iliac crest 10% EXSD 10% lunga ENSD 10% EXSD 10% EXSD

Front torso: iliac crest to pubis 10% EXSD 10% lunga 10% ENSD 10% EXSD 10% EXSD

Back torso: base of neck to mid-back ENSD Lunga EXSD ENSD ENSD

Back torso: mid-back to lowest rib ENSD Lunga EXSD ENSD ENSD

Back torso: lowest rib to iliac crest 10% ENSD 10% Lunga EXSD 10% ENSD 10% ENSD

Back torso: buttocks (Iliac crest and below) 10% ENSD 10% Lunga 10% EXSD 10% ENSD 10% ENSD

Right torso: base of neck to end of sternum ENSD ENSD ENSD EXSD ENSD

Right torso: end of sternum to lowest rib ENSD ENSD ENSD EXSD ENSD
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Area of skin

PA chest

after 1970

LAT chest

after 1970

AP lordotic chest

after 1970

RAO chest

after 1970

LAO chest

after 1970

Right torso: lowest rib to iliac crest 10% ENSD 10% ENSD ENSD 10% EXSD 10% ENSD

Right torso: iliac crest to pubis (R hip) 10% ENSD 10% ENSD 10% ENSD 10% EXSD 10% ENSD

Left torso: base of neck to end of sternum ENSD EXSD ENSD ENSD EXSD

Left torso: end of sternum to lowest rib ENSD EXSD ENSD ENSD EXSD

Left torso: lowest rib to iliac crest 10% ENSD 10% EXSD ENSD 10% ENSD 10% EXSD

Left torso: iliac crest to pubis (L hip) 10% ENSD 10% EXSD 10% ENSD 10% ENSD 10% EXSD

a. The higher of the male or female lung dose value should be used for both genders.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-9. Skin dose guidance for lumbar spine projections for the good collimation period after 1970.

a

Area of skin

AP and AP spot lumbar spine

after 1970

LAT and LAT spot lumbar spine

after 1970

LPO lumbar 

spine

after 1970

RPO lumbar 

spine

after 1970

R front shoulder 10% ENSD 10% ENSD 10% ENSD 10% ENSD

R back shoulder 10% EXSD 10% ENSD 10% ENSD 10% EXSD

L front shoulder 10% ENSD 10% EXSD 10% EXSD 10% ENSD

L back shoulder 10% EXSD 10% EXSD 10% EXSD 10% EXSD

R upper arm to elbow 10% ENSD 10% ENSD 10% ENSD 10% EXSD

L upper arm to elbow 10% ENSD 10% EXSD 10% EXSD 10% ENSD

L hand 10% ENSD 10% EXSD 10% EXSD 10% ENSD

R hand 10% ENSD 10% ENSD 10% ENSD 10% EXSD

L elbow, forearm, wrist 10% ENSD 10% EXSD 10% EXSD 10% ENSD

R elbow, forearm, wrist 10% ENSD 10% ENSD 10% ENSD 10% EXSD

R side of head (including temple and ear) Eye/brain Eye/brain Eye/brain Eye/brain

L side of head (including temple and ear) Eye/brain Eye/brain Eye/brain Eye/brain

Front L thigh 10% ENSD 10% EXSD 10% ENSD 10% ENSD

Back L thigh 10% EXSD 10% EXSD 10% EXSD 10% EXSD

Front R thigh 10% ENSD 10% ENSD 10% ENSD 10% ENSD

Back R thigh 10% EXSD 10% ENSD 10% EXSD 10% EXSD

L knee and below RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m)

R knee and below RSD (0.60 m) RSD (0.60 m) RSD (0.60 m) RSD (0.60 m)

L side of face Eye/brain Eye/brain Eye/brain Eye/brain

R side of face Eye/brain Eye/brain Eye/brain Eye/brain

L side of neck Eye/brain Eye/brain Eye/brain Eye/brain

R side of neck Eye/brain Eye/brain Eye/brain Eye/brain

Back of head Eye/brain Eye/brain Eye/brain Eye/brain

Front of neck Eye/brain Eye/brain Eye/brain Eye/brain

Back of neck Eye/brain Eye/brain Eye/brain Eye/brain

Front torso: base of neck to end of 

sternum

10% ENSD Lungb 10% ENSD 10% ENSD

Front torso: end of sternum to lowest rib ENSD Lungb ENSD ENSD

Front torso: lowest rib to iliac crest ENSD Lungb ENSD ENSD

Front torso: iliac crest to pubis ENSD Lungb ENSD ENSD

Back torso: base of neck to mid-back 10% EXSD Lungb 10% EXSD 10% EXSD

Back torso: mid-back to lowest rib EXSD Lungb EXSD EXSD

Back torso: lowest rib to iliac crest EXSD Lungb EXSD EXSD
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Area of skin

AP and AP spot lumbar spine

after 1970

LAT and LAT spot lumbar spine

after 1970

LPO lumbar 

spine

after 1970

RPO lumbar 

spine

after 1970

Back torso: buttocks (Iliac crest and 

below)

EXSD Lungb EXSD EXSD

Right torso: base of neck to end of 

sternum

10% ENSD 10% ENSD 10% ENSD 10% EXSD

Right torso: end of sternum to lowest rib ENSD ENSD ENSD EXSD

Right torso: lowest rib to iliac crest ENSD ENSD ENSD EXSD

Right torso: iliac crest to pubis (R hip) ENSD ENSD ENSD EXSD

Left torso: base of neck to end of sternum 10% ENSD 10% EXSD 10% EXSD 10% ENSD

Left torso: end of sternum to lowest rib ENSD EXSD EXSD ENSD

Left torso: lowest rib to iliac crest ENSD EXSD EXSD ENSD

Left torso: iliac crest to pubis (L hip) ENSD EXSD EXSD ENSD

a. The pelvis, thoracic spine, and cervical spine would not have been performed for screening after 1970.

b. The higher of the male or female lung dose value should be used for both genders.
ATTACHMENT B

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Table B-10. Organ dose equivalents (rem) for chest projections for all periods.

a

Organ Projection

Through 

1970 1971–1985

1986 and 

later

Thyroid PFG

b 3.94E−01 Not used Not used

Thyroid PA 3.48E−02 3.20E−03 3.90E−03

Thyroid LAT/OBL 6.85E−02 2.88E−02 2.13E−02

Thyroid AP lordotic 1.74E−01 3.17E−02 Not used

Thyroid Fluoroscopy

c 3.75E−01 Not used Not used

Eye/brain PFG

b 7.25E−02 Not used Not used

Eye/brain PA 6.40E−03 3.20E−03 3.90E−03

Eye/brain LAT/OBL5.75E−02 2.88E−02 2.13E−02

Eye/brain AP lordotic 1.74E−01 3.17E−02 Not used

Eye/brain Fluoroscopy

c 5.25E−02 Not used Not used

Ovaries

b PFGb 2.50E−02d Not used Not used

Ovaries PA 2.50E−02

d 1.00E−04 2.60E−04

Ovaries LAT/OBL 1.30E−02

d 1.50E−04 3.25E−04

Ovaries AP lordotic 4.66E−02 2.00E−04 Not used

Ovaries Fluoroscopy

c 1.50E−03 Not used Not used

Urinary/bladder/prostate

b PFGb 2.50E−02d Not used Not used

Urinary/bladder/prostate PA 2.50E−02

d 1.00E−04 2.60E−04

Urinary/bladder/prostate LAT/OBL 1.30E−02

d 1.50E−04 3.25E−04

Urinary/bladder/prostate AP lordotic 4.66E−02 2.00E−04 Not used

Urinary/bladder/prostate Fluoroscopy

c 1.50E−03 Not used Not used

Colon/rectum

b PFGb 2.50E−02d Not used Not used

Colon/rectum PA 2.50E−02

d 1.00E−04 2.60E−04

Colon/rectum LAT/OBL 1.30E−02

d 1.50E−04 3.25E−04

Colon/rectum AP lordotic 4.66E−02 2.00E−04 Not used

Colon/rectum Fluoroscopy

c 1.50E−03 Not used Not used

Testes

b PFGb 5.00E−03d Not used Not used

Testes PA 5.00E−03

d 1.00E−06 5.00E−07

Testes LAT/OBL 2.50E−03 2.50E−05 1.30E−05

Testes AP lordotic 3.60E−03 1.00E−06 Not used

Testes Fluoroscopy

c 2.50E−05 Not used Not used

Lungs (male) PFG

b 9.50E−01 Not used Not used

Lungs (male) PA 8.38E−02 4.19E−02 3.14E−02

Lungs (male) LAT/OBL 9.65E−02 4.83E−02 4.07E−02

Lungs (male) AP lordotic 9.46E−02 4.73E−02 Not used

Lungs (male) Fluoroscopy

c 8.38E−01 Not used Not used
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Organ Projection

Through 

1970 1971–1985

1986 and 

later

Lungs (female) PFG

b 1.02E−00 Not used Not used

Lungs (female) PA 9.02E−02 4.51E−02 3.37E−02

Lungs (female) LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Lungs (female) AP lordotic 7.06E−02 3.53E−02 Not used

Lungs (female) Fluoroscopy

c 8.88E−01 Not used Not used

Thymus PFG

b 1.02E−00 Not used Not used

Thymus PA 9.02E−02 4.51E−02 3.37E−02

Thymus LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Thymus AP lordotic 9.46E−02 4.73E−02 Not used

Thymus Fluoroscopy

c 8.88E−01 Not used Not used

Esophagus PFG

b 1.02E−00 Not used Not used

Esophagus PA 9.02E−02 4.51E−02 3.37E−02

Esophagus LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Esophagus AP lordotic 9.46E−02 4.73E−02 Not used

Esophagus Fluoroscopy

c 8.88E−01 Not used Not used

Stomach PFG

b 1.02E−00 Not used Not used

Stomach PA 9.02E−02 4.51E−02 3.37E−02

Stomach LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Stomach AP lordotic 9.46E−02 4.73E−02 Not used

Stomach Fluoroscopy

c 8.88E−01 Not used Not used

Bone surface PFG

b 1.02E−00 Not used Not used

Bone surface PA 9.02E−02 4.51E−02 3.37E−02

Bone surface LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Bone surface AP lordotic 9.46E−02 4.73E−02 Not used

Bone surface Fluoroscopy

c 8.88E−01 Not used Not used

Liver/gallbladder/spleen PFG

b 1.02E−00 Not used Not used

Liver/gallbladder/spleen PA 9.02E−02 4.51E−02 3.37E−02

Liver/gallbladder/spleen LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Liver/gallbladder/spleen AP lordotic 9.46E−02 4.73E−02 Not used

Liver/gallbladder/spleen Fluoroscopy

c 8.88E−01 Not used Not used

Remainder organs PFG

b 1.02E−00 Not used Not used

Remainder organs PA 9.02E−02 4.51E−02 3.37E−02

Remainder organs LAT/OBL 1.10E−01 5.50E−02 4.56E−02

Remainder organs AP lordotic 9.46E−02 4.73E−02 Not used

Remainder organs Fluoroscopy

c 8.88E−01 Not used Not used

Breast PFG

b 1.11E−01 Not used Not used
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Organ Projection

Through 

1970 1971–1985

1986 and 

later

Breast PA 9.80E−03 4.90E−03 5.80E−03

Breast LAT/OBL 1.28E−01 6.38E−02 4.46E−02

Breast AP lordotic 1.67E−01 8.36E−02 Not used

Breast Fluoroscopy

c 8.00E−02 Not used Not used

Uterus PFG

b 2.50E−02d Not used Not used

Uterus PA 2.50E−02

d 1.30E−04 2.60E−04

Uterus LAT/OBL 1.30E−02

d 1.50E−04 2.73E−04

Uterus AP lordotic 6.10E−02 1.50E−04 Not used

Uterus Fluoroscopy

c 1.75E−03 Not used Not used

Bone marrow (male) PFG

b 2.09E−01 Not used Not used

Bone marrow (male) PA 1.84E−02 9.20E−03 8.90E−03

Bone marrow (male) LAT/OBL 1.85E−02 9.25E−03 9.88E−03

Bone marrow (male) AP lordotic 9.60E−03 4.80E−03 Not used

Bone marrow (male) Fluoroscopy

c 1.73E−01 Not used Not used

Bone marrow (female) PFG

b 1.95E−01 Not used Not used

Bone marrow (female) PA 1.72E−02 8.60E−03 8.60E−03

Bone marrow (female) LAT/OBL 1.45E−02 7.25E−03 7.67E−03

Bone marrow (female) AP lordotic 9.60E−03 4.80E−03 Not used

Bone marrow (female) Fluoroscopy

c 1.58E−01 Not used Not used

Entrance skin

e PFGb 3.06E+00 Not used Not used

Entrance skin PA 2.70E−01 1.35E−01 7.00E−02

Entrance skin LAT/OBL 6.75E−01 3.38E−01 1.82E−01

Entrance skin AP lordotic 2.70E−01 1.35E−01 Not used

Entrance skin Fluoroscopy

c 3.30E+00 Not used Not used

a. Not used means projection not performed for screening in this period.

b. PFG dose equivalents are for stereo projections (two exposures). If only one projection was 

taken, these dose equivalents should be halved. See Section 7.2 for additional information.

c. Fluoroscopy dose equivalents based on 5 R/min for 30 seconds with an HVL of 2.0 mm Al eq.

d. Dose equivalents through 1970 are based on measured values (Rising and Soldat 1959; 

Webster and Merrill 1957) for testes, ovaries, uterus, and analogues.

e. ENSD equivalents determined by multiplying the incident air kerma by the backscatter factors 

of 1.32,1.35 and 1.42 for HVL of 2.0 mm Al, 2.5 mm Al and 4.0 mm Al, respectively, from 

NCRP Report 102 (NCRP 1989, Table B-8). Skin dose equivalents for all areas of skin are 

provided in Tables B-11 and B-12. 
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-11. Skin dose equivalents (rem) from chest projections through 1970.

a

Area of skin

PFGb

1943–1970

Chest

fluoroscopy

through 

1970

PA

chest 

through 

1970

LAT

chest 

through 

1970

AP lordotic 

chest 

through 

1970

RAO

chest 

through 

1970

LAO

chest 

through 

1970

Right front shoulder 6.67E−02 6.32E−02 5.9E−03 6.75E−01 2.70E−01 3.0E−03 3.0E−03

Right back shoulder 3.06E+00 3.30E+00 2.70E−01 6.75E−01 5.9E−03 6.75E−01 6.75E−01

Left front shoulder 6.67E−02 6.32E−02 5.9E−03 3.0E−03 2.70E−01 3.0E−03 3.0E−03

Left back shoulder 3.06E+00 3.30E+00 2.70E−01 3.0E−03 5.9E−03 6.75E−01 6.75E−01

Right upper arm to elbow 3.06E−01 3.30E+00 2.70E−01 6.75E−01 2.70E−01 6.75E−01 6.75E−01

Left upper arm to elbow 3.06E−01 3.30E+00 2.70E−01 3.0E−03 2.70E−01 6.75E−01 6.75E−01

Left hand 3.06E+00 3.30E+00 2.70E−01 6.75E−02 2.70E−02 6.75E−02 6.75E−02

Right hand 3.06E+00 3.30E+00 2.70E−01 6.75E−02 2.70E−02 6.75E−02 6.75E−02

Left elbow, forearm, wrist 3.06E−01 3.30E+00 2.70E−01 6.75E−02 2.70E−01 6.75E−02 6.75E−02

Right elbow, forearm, wrist 3.06E−01 3.30E+00 2.70E−01 6.75E−02 2.70E−01 6.75E−02 6.75E−02

Right side of head including temple and ear 3.06E−01 3.30E−01 2.70E−02 5.75E−02 2.70E−02 3.E−04 6.75E−02

Left side of head including temple and ear 3.06E−01 3.30E−01 2.70E−02 5.75E−02 2.70E−02 6.75E−02 3.E−04

Front left thigh 9.E−04 8.E−04 8.E−05 1.E−04 8.E−05 1.E−04 1.E−04

Back left thigh 9.E−04 8.E−04 8.E−05 1.E−04 8.E−05 1.E−04 1.E−04

Front right thigh 9.E−04 8.E−04 8.E−05 1.E−04 8.E−05 1.E−04 1.E−04

Back right thigh 9.E−04 8.E−04 8.E−05 1.E−04 8.E−05 1.E−04 1.E−04

Left knee and below 3.E−04 3.E−04 3.E−05 4.E−05 3.E−05 4.E−05 4.E−05

Right knee and below 3.E−04 3.E−04 3.E−05 4.E−05 3.E−05 4.E−05 4.E−05

Left side of face 7.25E−02 5.25E−02 6.4E−03 5.75E−02 2.70E−01 6.75E−01 3.0E−03

Right side of face 7.25E−02 5.25E−02 6.4E−03 5.75E−02 2.70E−01 3.0E−03 6.75E−01

Left side of neck 3.06E−01 3.30E+00 2.70E−01 5.75E−02 2.70E−01 6.75E−01 3.0E−03

Right side of neck 3.06E−01 3.30E+00 2.70E−01 5.75E−02 2.70E−01 3.0E−03 6.75E−01

Back of head 3.06E−01 3.30E−01 2.70E−02 5.75E−02 5.9E−03 6.75E−02 6.75E−02

Front of neck 7.25E−02 5.25E−02 6.4E−03 5.75E−02 2.70E−01 5.75E−02 5.75E−02

Back of neck 3.06E−01 3.30E+00 2.70E−01 5.75E−02 5.9E−03 6.75E−01 6.75E−01

Front torso: base of neck to end of sternum 6.67E−02 6.32E−02 5.9E−03 1.10E−01 2.70E−01 3.0E−03 3.0E−03

Front torso: end of sternum to lowest rib 6.67E−02 6.32E−02 5.9E−03 1.10E−01 2.70E−01 3.0E−03 3.0E−03

Front torso: lowest rib to iliac crest 6.67E−02 6.32E−02 5.9E−03 1.10E−01 2.70E−01 3.0E−03 3.0E−03

Front torso: iliac crest to pubis 6.7E−03 6.3E−03 6.E−04 1.10E−02 2.70E−02 3.E−04 3.E−04

Back torso: base of neck to mid–back 3.06E+00 3.30E+00 2.70E−01 1.10E−01 5.9E−03 6.75E−01 6.75E−01

Back torso: mid–back to lowest rib 3.06E+00 3.30E+00 2.70E−01 1.10E−01 5.9E−03 6.75E−01 6.75E−01

Back torso: lowest rib to iliac crest 3.06E+00 3.30E+00 2.70E−01 1.10E−01 5.9E−03 6.75E−01 6.75E−01

Back torso: buttocks (Iliac crest and below) 3.06E−01 3.30E−01 2.70E−02 1.10E−02 6.E−04 6.75E−02 6.75E−02
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

6 Effective Date: 09/2

7/2019 Page 129 of 140

Area of skin

PFGb

1943–1970

Chest

fluoroscopy

through 

1970

PA

chest 

through 

1970

LAT

chest 

through 

1970

AP lordotic 

chest 

through 

1970

RAO

chest 

through 

1970

LAO

chest 

through 

1970

Right torso: base of neck to end of sternum 3.06E+00 3.30E+00 2.70E−01 6.75E−01 2.70E−01 3.0E−03 6.75E−01

Right torso: end of sternum to lowest rib 3.06E+00 3.30E+00 2.70E−01 6.75E−01 2.70E−01 3.0E−03 6.75E−01

Right torso: lowest rib to iliac crest 3.06E+00 3.30E+00 2.70E−01 6.75E−01 2.70E−01 3.0E−03 6.75E−01

Right torso: iliac crest to pubis (right hip) 3.06E−01 3.30E−01 2.70E−02 6.75E−02 2.70E−02 3.E−04 6.75E−02

Left torso: base of neck to end of sternum 3.06E+00 3.30E+00 2.70E−01 3.0E−03 2.70E−01 6.75E−01 3.0E−03

Left torso: end of sternum to lowest rib 3.06E+00 3.30E+00 2.70E−01 3.0E−03 2.70E−01 6.75E−01 3.0E−03

Left torso: lowest rib to iliac crest 3.06E+00 3.30E+00 2.70E−01 3.0E−03 2.70E−01 6.75E−01 3.0E−03

Left torso: iliac crest to pubis (Left hip) 3.06E−01 3.30E−01 2.70E−02 3.E−04 2.70E−02 6.75E−02 3.E−04

a. Values less than 0.1 mrem shown to one significant digit.

b. PFG dose equivalents are for stereo projections (two exposures). If only one projection was taken, these dose equivalents should be halved. See Section 7.2 for 

additional information.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

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7/2019 Page 130 of 140

Table B-12. Skin dose equivalents (rem) from various chest projections after 1970.

a

Area of skin

PA

chest 

1971–1985

LAT

chest 

1971–1985

AP lordotic 

chest 

1971–1985

RAO

chest 

1971–1985

LAO

chest 

1971–1985

PA

chest

after 1985

LAT

chest

after 1985

RAO

chest

after 1985

LAO

chest

after 1985

Right front shoulder 2.9E−03 3.38E−01 1.35E−01 1.5E−03 1.5E−03 2.4E−03 1.82E−01 1.4E−03 1.4E−03

Right back shoulder 1.35E−01 3.38E−01 2.9E−03 3.38E−01 3.38E−01 7.00E−02 1.82E−01 1.82E−01 1.82E−01

Left front shoulder 2.9E−03 1.5E−03 1.35E−01 1.5E−03 1.5E−03 2.4E−03 1.4E−03 1.4E−03 1.4E−03

Left back shoulder 1.35E−01 1.5E−03 2.9E−03 3.38E−01 3.38E−01 7.00E−02 1.4E−03 1.82E−01 1.82E−01

Right upper arm to elbow 1.35E−02 3.38E−01 1.35E−01 3.38E−02 3.38E−02 7.0E−03 1.82E−01 1.82E−02 1.82E−02

Left upper arm to elbow 1.35E−02 1.5E−03 1.35E−01 3.38E−02 3.38E−02 7.0E−03 1.4E−03 1.82E−02 1.82E−02

Left hand 1.35E−02 3.38E−02 1.35E−02 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Right hand 1.35E−02 3.38E−02 1.35E−02 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Left elbow, forearm, wrist 1.35E−02 3.38E−02 1.35E−01 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Right elbow, forearm, 

wrist

1.35E−02 3.38E−02 1.35E−01 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Right side of head 

including temple and ear

1.35E−02 3.38E−02 1.35E−02 1.E−04 3.38E−02 7.0E−03 1.82E−02 1.E−04 1.82E−02

Left side of head 

including temple and ear

1.35E−02 3.38E−02 1.35E−02 3.38E−02 1.E−04 7.0E−03 1.82E−02 1.82E−02 1.E−04

Front left thigh 4.E−05 5.E−05 4.E−05 5.E−05 5.E−05 3.E−05 4.E−05 4.E−05 4.E−05

Back left thigh 4.E−05 5.E−05 4.E−05 5.E−05 5.E−05 3.E−05 4.E−05 4.E−05 4.E−05

Front right thigh 4.E−05 5.E−05 4.E−05 5.E−05 5.E−05 3.E−05 4.E−05 4.E−05 4.E−05

Back right thigh 4.E−05 5.E−05 4.E−05 5.E−05 5.E−05 3.E−05 4.E−05 4.E−05 4.E−05

Left knee and below 1.E−05 2.E−05 1.E−05 2.E−05 2.E−05 1.E−05 1.E−05 1.E−05 1.E−05

Right knee and below 1.E−05 2.E−05 1.E−05 2.E−05 2.E−05 1.E−05 1.E−05 1.E−05 1.E−05

Left side of face 3.2E−03 3.38E−02 1.35E−01 3.38E−02 1.E−04 3.9E−03 1.82E−02 1.82E−02 1.E−04

Right side of face 3.2E−03 3.38E−02 1.35E−01 1.E−04 3.38E−02 3.9E−03 1.82E−02 1.E−04 1.82E−02

Left side of neck 1.35E−02 3.38E−02 1.35E−01 3.38E−02 1.E−04 7.0E−03 1.82E−02 1.82E−02 1.E−04

Right side of neck 1.35E−02 3.38E−02 1.35E−01 1.E−04 3.38E−02 7.0E−03 1.82E−02 1.E−04 1.82E−02

Back of head 1.35E−02 3.38E−02 2.9E−03 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Front of neck 3.2E−03 3.38E−02 1.35E−01 2.88E−02 2.88E−02 3.9E−03 1.82E−02 2.13E−02 2.13E−02

Back of neck 1.35E−02 3.38E−02 2.9E−03 3.38E−02 3.38E−02 7.0E−03 1.82E−02 1.82E−02 1.82E−02

Front torso: base of neck 

to end of sternum

2.9E−03 5.50E−02 1.35E−01 1.5E−03 1.5E−03 2.4E−03 4.56E−02 1.4E−03 1.4E−03

Front torso: end of 

sternum to lowest rib

2.9E−03 5.50E−02 1.35E−01 1.5E−03 1.5E−03 2.4E−03 4.56E−02 1.4E−03 1.4E−03

Front torso: lowest rib to 

iliac crest

3.E−04 5.5E−03 1.35E−01 1.E−04 1.E−04 2.E−04 4.6E−03 1.E−04 1.E−04
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

6 Effective Date: 09/2

7/2019 Page 131 of 140

Area of skin

PA

chest 

1971–1985

LAT

chest 

1971–1985

AP lordotic 

chest 

1971–1985

RAO

chest 

1971–1985

LAO

chest 

1971–1985

PA

chest

after 1985

LAT

chest

after 1985

RAO

chest

after 1985

LAO

chest

after 1985

Front torso: iliac crest to 

pubis

3.E−04 5.5E−03 1.35E−02 1.E−04 1.E−04 2.E−04 4.6E−03 1.E−04 1.E−04

Back torso: base of neck 

to mid–back

1.35E−01 5.50E−02 2.9E−03 3.38E−01 3.38E−01 7.00E−02 4.56E−02 1.82E−01 1.82E−01

Back torso: mid–back to 

lowest rib

1.35E−01 5.50E−02 2.9E−03 3.38E−01 3.38E−01 7.00E−02 4.56E−02 1.82E−01 1.82E−01

Back torso: lowest rib to 

iliac crest

1.35E−02 5.5E−03 2.9E−03 3.38E−02 3.38E−02 7.0E−03 4.6E−03 1.82E−02 1.82E−02

Back torso: buttocks 

(Iliac crest and below)

1.35E−02 5.5E−03 3.E−04 3.38E−02 3.38E−02 7.0E−03 4.6E−03 1.82E−02 1.82E−02

Right torso: base of neck 

to end of sternum

1.35E−01 3.38E−01 1.35E−01 1.5E−03 3.38E−01 7.00E−02 1.82E−01 1.4E−03 1.82E−01

Right torso: end of 

sternum to lowest rib

1.35E−01 3.38E−01 1.35E−01 1.5E−03 3.38E−01 7.00E−02 1.82E−01 1.4E−03 1.82E−01

Right torso: lowest rib to 

iliac crest

1.35E−02 3.38E−02 1.35E−01 1.E−04 3.38E−02 7.0E−03 1.82E−02 1.E−04 1.82E−02

Right torso: iliac crest to 

pubis (right hip)

1.35E−02 3.38E−02 1.35E−02 1.E−04 3.38E−02 7.0E−03 1.82E−02 1.E−04 1.82E−02

Left torso: base of neck 

to end of sternum

1.35E−01 1.5E−03 1.35E−01 3.38E−01 1.5E−03 7.00E−02 1.4E−03 1.82E−01 1.4E−03

Left torso: end of 

sternum to lowest rib

1.35E−01 1.5E−03 1.35E−01 3.38E−01 1.5E−03 7.00E−02 1.4E−03 1.82E−01 1.4E−03

Left torso: lowest rib to 

iliac crest

1.35E−02 1.E−04 1.35E−01 3.38E−02 1.E−04 7.0E−03 1.E−04 1.82E−02 1.E−04

Left torso: iliac crest to 

pubis (Left hip)

1.35E−02 1.E−04 1.35E−02 3.38E−02 1.E−04 7.0E−03 1.E−04 1.82E−02 1.E−04

a. Values less than 0.1 mrem shown to one significant digit.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 132 of 140

Table B-13. Organ dose equivalents (rem) for lumbar spine and pelvis 

projections for all periods.

a,b

Organ Projection

Through 

1970 1971−1985

Thyroid AP or AP spot lumbar spine

c 2.88E−04

2.33E−04

Thyroid LAT or LAT spot lumbar spine

d 3.79E−05 2.80E−05

Thyroid AP pelvis 1.52E−05 Not used

Eye/brain AP or AP spot lumbar spine

c 2.88E−04

2.33E−04

Eye/brain LAT or LAT spot lumbar spine

d 3.79E−05 2.80E−05

Eye/brain AP pelvis 1.52E−05 Not used

Ovaries

b AP or AP spot lumbar spinec 5.60E−01 1.6

8E−01

Ovaries LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Ovaries AP pelvis 6.50E−01 Not used

Urinary

bladder/prostate

e,f

AP or AP spot lumbar spine

c 5.60E−01 1.68E−01

Urinary bladder/prostate LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Urinary bladder/prostate AP pelvis 6.50E−01 Not used

Colon/rectum

e,f AP or AP spot lumbar spinec 5.60E−01 1.68E−01

Colon/rectum LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Colon/rectum AP pelvis 6.50E−01 Not used

Testes

b AP or AP spot lumbar spinec 2.70E−02

3.26E−03

Testes LAT or LAT spot lumbar spine

d 5.60E−02 2.24E−03

Testes AP pelvis 6.40E−01 Not used

Lungs (male) AP or AP spot lumbar spine

c 8.93E−02

6.13E−02

Lungs (male) LAT or LAT spot lumbar spine

d 3.79E−02 3.92E−02

Lungs (male) AP pelvis 1.52E−03 Not used

Lungs (female) AP or AP spot lumbar spine

c 8.93E−02

6.13E−02

Lungs (female) LAT or LAT spot lumbar spine

d 3.79E−02 3.92E−02

Lungs (female) AP pelvis 1.52E−03 Not used

Thymus AP or AP spot lumbar spine

c 8.93E−02

6.13E−02

Thymus LAT or LAT spot lumbar spine

d 3.79E−02 3.92E−02

Thymus AP pelvis 1.52E−03 Not used

Esophagus AP or AP spot lumbar spine

c 8.93E−02

6.13E−02

Esophagus LAT or LAT spot lumbar spine

d 3.79E−02 3.92E−02

Esophagus AP pelvis 1.52E−03 Not used

Stomach

e,f AP or AP spot lumbar spinec 5.60E−01 1.68E−01

Stomach LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Stomach AP pelvis 6.50E−01 Not used
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 133 of 140

Organ Projection

Through 

1970 1971−1985

Bone surface

e,f AP or AP spot lumbar spinec 5.60E−01 1.68E−01

Bone surface LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Bone surface AP pelvis 6.50E−01 Not used

Liver/gallbladder/spleen

e,f AP or AP spot lumbar spinec 5.60E−01 1.68E−01

Liver/gallbladder/spleen LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Liver/gallbladder/spleen AP pelvis 6.50E−01 Not used

Remainder organs

e,f AP or AP spot lumbar spinec 5.60E−01 1.68E−01

Remainder organs LAT or LAT spot lumbar spine

d 7.10E−01 1.32E−01

Remainder organs AP pelvis 6.50E−01 Not used

Breast AP or AP spot lumbar spine

c 8.93E−02 6.13E−02

Breast LAT or LAT spot lumbar spine

d 3.79E−02 3.92E−02

Breast AP pelvis 1.52E−03 Not used

Uterus

e AP or AP spot lumbar spinec 5.60E−01 2.23E−01

Uterus LAT or LAT spot lumbar spine

d 7.10E−01 8.68E−02

Uterus AP pelvis 6.50E−01 Not used

Bone marrow (male) AP or AP spot lumbar spine

c 3.46E−02 2.8

7E−02

Bone marrow (male) LAT or LAT spot lumbar spine

d 5.69E−02 6.16E−02

Bone marrow (male) AP pelvis 3.50E−02 Not used

Bone marrow (female) AP or AP spot lumbar spine

c 3.46E−02 2.8

7E−02

Bone marrow (female) LAT or LAT spot lumbar spine

d 5.69E−02 6.16E−02

Bone marrow (female) AP pelvis 3.50E−02 Not used

Entrance skin

g AP or AP spot lumbar spinec 1.900E+00 1.05E+00

Entrance skin LAT or LAT spot lumbar spine

d 5.00E+00 3.79E+00

Entrance skin AP pelvis 2.000E+00 Not used

a. Not used means projection not performed for screening in this period.

b. Doses through 1970 are based on measured values (Lincoln and Gupton 1958) for skin, 

testes, and ovaries.

c. Dose equivalents are for one projection. If both AP and AP spot are being included as the 

default frequency, the listed dose equivalents should be doubled.

d. Dose equivalents are for one projection. If both LAT and LAT spot are being included as the 

default frequency, the listed dose equivalents should be doubled.

e. The ovary measured dose is used to determine organ dose equivalents for the Remainder 

organs and other organs in the primary beam for projections of the lumbar spine and pelvis

through 1970. 

f. The ovary DCF is used to determine organ dose equivalents for the Remainder organs and 

other organs in the primary beam for projections of the lumbar spine and pelvis for 1971−1985. 

g. Skin dose equivalents for all areas of skin are provided in Tables B-14. 
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

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Table B-14. Skin dose equivalent (rem) from lumbar spine and pelvis projections for all periods.

a

Area of skin

AP or AP spot 

lumbar spine 

through 1970

LAT or LAT spot 

lumbar spine 

through 1970

Pelvis

through 1970

AP or AP spot 

lumbar spine

1971−1985

LAT or LAT spot 

lumbar spine 

1971−1985

Right front shoulder 1.90E−01 5.00E−01 2.00E−01 1.05E−01 3.79E−01

Right back shoulder 3.6E−03 5.00E−01 3.8E−03 2.62E−03 3.79E−01

Left front shoulder 1.90E−01 1.90E−03 2.00E−01 1.05E−01 1.66E−03

Left back shoulder 3.6E−03 1.90E−03 3.8E−03 2.62E−03 1.66E−03

Right upper arm to elbow 1.90E−01 5.00E−01 2.00E−01 1.05E−01 3.79E−01

Left upper arm to elbow 1.90E−01 1.90E−03 2.00E−01 1.05E−01 1.66E−03

Left hand 1.90E+00 1.90E−03 2.00E+00 1.05E−01 1.66E−03

Right hand 1.90E+00 5.00E−01 2.00E+00 1.05E−01 3.79E−01

Left elbow, forearm, wrist 1.90E+00 1.90E−03 2.00E+00 1.05E−01 1.66E−03

Right elbow, forearm, wrist 1.90E+00 5.00E−01 2.00E+00 1.05E−01 3.79E−01

Right side of head including temple and ear 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Left side of head including temple and ear 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Front left thigh 1.90E−01 1.90E−03 2.00E−01 1.05E−01 1.66E−03

Back left thigh 3.6E−03 1.90E−03 3.8E−03 2.62E−03 1.66E−03

Front right thigh 1.90E−01 5.00E−01 2.00E−01 1.05E−01 3.79E−01

Back right thigh 3.6E−03 5.00E−01 3.8E−03 2.62E−03 3.79E−01

Left knee and below 4.E−04 5.E−04 4.E−04 2.47E−04 3.83E−04

Right knee and below 4.E−04 5.E−04 4.E−04 2.47E−04 3.83E−04

Left side of face 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Right side of face 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Left side of neck 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Right side of neck 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Back of head 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Front of neck 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Back of neck 3.E−04 3.E−05 1.E−05 2.33E−04 2.80E−05

Front torso: base of neck to end of sternum 1.90E−01 3.32E−02 2.00E−01 1.05E−01 3.92E−02

Front torso: end of sternum to lowest rib 1.90E+00 3.32E−02 2.00E+00 1.05E+00 3.92E−02

Front torso: lowest rib to iliac crest 1.90E+00 3.32E−02 2.00E+00 1.05E+00 3.92E−02

Front torso: iliac crest to pubis 1.90E+00 3.32E−02 2.00E+00 1.05E+00 3.92E−02

Back torso: base of neck to mid–back 3.6E−03 3.32E−02 3.8E−03 2.62E−03 3.92E−02

Back torso: mid–back to lowest rib 3.64E−02 3.32E−02 3.83E−02 2.62E−02 3.92E−02

Back torso: lowest rib to iliac crest 3.64E−02 3.32E−02 3.83E−02 2.62E−02 3.92E−02

Back torso: buttocks (Iliac crest and below) 3.64E−02 3.32E−02 3.83E−02 2.62E−02 3.92E−02

Right torso: base of neck to end of sternum 1.90E−01 5.00E−01 2.00E−01 1.05E−01 3.79E−01
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

6 Effective Date: 09/2

7/2019 Page 135 of 140

Area of skin

AP or AP spot 

lumbar spine 

through 1970

LAT or LAT spot 

lumbar spine 

through 1970

Pelvis

through 1970

AP or AP spot 

lumbar spine

1971−1985

LAT or LAT spot 

lumbar spine 

1971−1985

Right torso: end of sternum to lowest rib 1.90E+00 5.00E+00 2.00E+00 1.05E+00 3.79E+00

Right torso: lowest rib to iliac crest 1.90E+00 5.00E+00 2.00E+00 1.05E+00 3.79E+00

Right torso: iliac crest to pubis (right hip) 1.90E+00 5.00E+00 2.00E+00 1.05E+00 3.79E+00

Left torso: base of neck to end of sternum 1.90E−01 1.90E−03 2.00E−01 1.05E−01 1.66E−03

Left torso: end of sternum to lowest rib 1.90E+00 1.90E−02 2.00E+00 1.05E+00 1.66E−02

Left torso: lowest rib to iliac crest 1.90E+00 1.90E−02 2.00E+00 1.05E+00 1.66E−02

Left torso: iliac crest to pubis (left hip) 1.90E+00 1.90E−02 2.00E+00 1.05E+00 1.66E−02

a. Values less than 0.1 mrem shown to one significant digit.
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 136 of 140

Table B-15. Organ dose equivalents (rem) for thoracic and cervical spine 

projections through 1970.

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

Thyroid AP 9.26E−02 AP 3.25E−01

Thyroid LAT 1.23E−01 LAT 1.46E−02

Thyroid RPO 1.23E−01 RPO 3.25E−01

Thyroid LPO 1.23E−01 LPO 3.25E−01

Eye/brain AP 9.26E−03 AP 3.25E−01

Eye/brain LAT 8.80E−03 LAT 1.46E−02

Eye/brain RPO 8.80E−03 RPO 3.25E−01

Eye/brain LPO 8.80E−03 LPO 3.25E−01

Ovaries AP 2.80E−02

a AP 6.00E−05a

Ovaries LAT 4.60E−02

a LAT 2.00E−04a

Ovaries RPO 4.60E−02 RPO 6.00E−05

Ovaries LPO 4.60E−02 LPO 6.00E−05

Urinary/bladder/prostate AP 2.80E−02

a AP 6.00E−05

Urinary/bladder/prostate LAT 4.60E−02

a LAT 2.00E−04

Urinary/bladder/prostate RPO 4.60E−02 RPO 6.00E−05

Urinary/bladder/prostate LPO 4.60E−02 LPO 6.00E−05

Colon/rectum AP 2.80E−02

a AP 6.00E−05

Colon/rectum LAT 4.60E−02

a LAT 2.00E−04

Colon/rectum RPO 4.60E−02 RPO 6.00E−05

Colon/rectum LPO 4.60E−02 LPO 6.00E−05

Testes AP 1.00E−03

a AP 2.70E−04a

Testes LAT 2.00E−03

a LAT 9.20E−04a

Testes RPO 2.00E−03 RPO 2.70E−04

Testes LPO 2.00E−03 LPO 2.70E−04

Lungs (male) AP 3.27E−01

b AP 6.48E−03

Lungs (male) LAT 2.35E−01

b LAT 5.98E−03

Lungs (male) RPO 2.35E−01 RPO 6.48E−03

Lungs (male) LPO 2.35E−01 LPO 6.48E−03

Lungs (female) AP 2.33E−01

b AP 6.48E−03

Lungs (female) LAT 2.82E−01

b LAT 5.98E−03

Lungs (female) RPO 2.82E−01 RPO 6.48E−03

Lungs (female) LPO 2.82E−01 LPO 6.48E−03
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 137 of 140

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

Thymus AP 3.27E−01

b AP 6.48E−03

Thymus LAT 2.82E−01

b LAT 5.98E−03

Thymus RPO 2.82E−01 RPO 6.48E−03

Thymus LPO 2.82E−01 LPO 6.48E−03

Esophagus AP 3.27E−01

b AP 6.48E−03

Esophagus LAT 2.82E−01

b LAT 5.98E−03

Esophagus RPO 2.82E−01 RPO 6.48E−03

Esophagus LPO 2.82E−01 LPO 6.48E−03

Stomach AP 3.27E−01

b AP 6.48E−03

Stomach LAT 2.82E−01

b LAT 5.98E−03

Stomach RPO 2.82E−01 RPO 6.48E−03

Stomach LPO 2.82E−01 LPO 6.48E−03

Bone surface AP 3.27E−01

b AP 6.48E−03

Bone surface LAT 2.82E−01

b LAT 5.98E−03

Bone surface RPO 2.82E−01 RPO 6.48E−03

Bone surface LPO 2.82E−01 LPO 6.48E−03

Liver/gallbladder/spleen AP 3.27E−01

b AP 6.48E−03

Liver/gallbladder/spleen LAT 2.82E−01

b LAT 5.98E−03

Liver/gallbladder/spleen RPO 2.82E−01 RPO 6.48E−03

Liver/gallbladder/spleen LPO 2.82E−01 LPO 6.48E−03

Remainder organs AP 3.27E−01

b AP 6.48E−03

Remainder organs LAT 2.82E−01

b LAT 5.98E−03

Remainder organs RPO 2.82E−01 RPO 6.48E−03

Remainder organs LPO 2.82E−01 LPO 6.48E−03

Breast AP 3.61E−01 AP 6.48E−03

Breast LAT 1.23E−02 LAT 5.98E−03

Breast RPO 1.23E−02 RPO 6.48E−03

Breast LPO 1.23E−02 LPO 6.48E−03

Uterus AP 2.80E−02

a AP 6.00E−05a

Uterus LAT 4.60E−02

a LAT 2.00E−04a

Uterus RPO 4.60E−02 RPO 6.00E−05

Uterus LPO 4.60E−02 LPO 6.00E−05
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 06 Effective Date: 09/27/2019 Page 138 of 140

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

Bone marrow (male) AP 2.86E−02 AP 4.75E−03

Bone marrow (male) LAT 3.96E−02 LAT 4.42E−03

Bone marrow (male) RPO 3.96E−02 RPO 4.75E−03

Bone marrow (male) LPO 3.96E−02 LPO 4.75E−03

Bone marrow (female) AP 2.27E−02 AP 4.75E−03

Bone marrow (female) LAT 3.08E−02 LAT 4.42E−03

Bone marrow (female) RPO 3.08E−02 RPO 4.75E−03

Bone marrow (female) LPO 3.08E−02 LPO 4.75E−03

Entrance skin

c AP 1.30E+00a AP 5.70E−01

Entrance skin LAT 2.90E+00

a LAT 3.43E−01

Entrance skin RPO 2.90E+00 RPO 5.70E−01

Entrance skin LPO 2.90E+00 LPO 5.70E−01

a. Dose equivalents through 1970 are based on measured values (Lincoln and Gupton 1958) 

for skin, testes, ovaries, and uterus for the thoracic spine, and measured values (Braestrup 

and Wycoff 1958, p.81, Table VII) for testes, ovaries, and uterus for the cervical spine.

b. The higher of the two lung DCFs is used to determine organ dose equivalents for the 

remainder organs and other organs in the primary beam for projections of the thoracic 

spine.

c. Skin dose equivalents for all areas of skin are provided in Tables B-16. 
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

6 Effective Date: 09/2

7/2019 Page 139 of 140

Table B-16. Skin dose equivalent (rem) from thoracic and cervical spine projections through 1970.

a

Area of skin

AP

thoracic 

spine

LAT

thoracic 

spine

RPO

thoracic 

spine

LPO

thoracic 

spine

AP

cervical 

spine

LAT

cervical 

spine

RPO

cervical 

spine

LPO

cervical 

spine

Right front shoulder 1.30E+00 2.90E+00 2.90E+00 2.90E+00 5.70E−02 3.43E−01 5.70E−02 5.70E−02

Right back shoulder 2.49E−02 2.90E+00 1.10E−02 1.10E−02 1.1E−03 3.43E−01 1.1E−03 1.1E−03

Left front shoulder 1.30E+00 1.10E−02 2.90E+00 2.90E+00 5.70E−02 1.3E−03 5.70E−02 5.70E−02

Left back shoulder 2.49E−02 1.10E−02 1.10E−02 1.10E−02 1.1E−03 1.3E−03 1.1E−03 1.1E−03

Right upper arm to elbow 1.30E+00 2.90E+00 2.90E+00 2.90E+00 5.70E−02 3.43E−02 1.1E−03 5.70E−02

Left upper arm to elbow 1.30E+00 1.10E−02 2.90E+00 2.90E+00 5.70E−02 1.E−04 5.70E−02 5.70E−02

Left hand 1.30E−01 2.90E−01 2.90E−01 2.90E−01 4.E−04 3.E−04 4.E−04 4.E−04

Right hand 1.30E−01 2.90E−01 2.90E−01 2.90E−01 4.E−04 3.E−04 4.E−04 4.E−04

Left elbow, forearm, wrist 1.30E+00 2.90E−01 2.90E−01 2.90E−01 4.E−04 3.E−04 4.E−04 4.E−04

Right elbow, forearm, wrist 1.30E+00 2.90E−01 2.90E−01 2.90E−01 4.E−04 3.E−04 4.E−04 4.E−04

Right side of head including temple and ear 1.30E−01 2.90E−01 1.1E−03 2.90E−01 5.70E−01 3.43E−01 4.76E−02 5.70E−01

Left side of head including temple and ear 1.30E−01 2.90E−01 2.90E−01 1.1E−03 5.70E−01 2.87E−02 5.70E−01 4.76E−02

Front left thigh 3.E−04 4.E−04 4.E−04 4.E−04 1.E−04 9.E−05 1.E−04 1.E−04

Back left thigh 3.E−04 4.E−04 4.E−04 4.E−04 1.E−04 9.E−05 1.E−04 1.E−04

Front right thigh 3.E−04 4.E−04 4.E−04 4.E−04 1.E−04 9.E−05 1.E−04 1.E−04

Back right thigh 3.E−04 4.E−04 4.E−04 4.E−04 1.E−04 9.E−05 1.E−04 1.E−04

Left knee and below 1.E−04 1.E−04 1.E−04 1.E−04 7.E−05 4.E−05 7.E−05 7.E−05

Right knee and below 1.E−04 1.E−04 1.E−04 1.E−04 7.E−05 4.E−05 7.E−05 7.E−05

Left side of face 1.30E−01 7.7E−03 2.90E−01 1.1E−03 5.70E−01 2.87E−02 5.70E−01 4.76E−02

Right side of face 1.30E−01 7.7E−03 1.1E−03 2.90E−01 5.70E−01 3.43E−01 4.76E−02 5.70E−01

Left side of neck 1.30E+00 7.7E−03 2.90E+00 1.10E−02 5.70E−01 2.87E−02 5.70E−01 4.76E−02

Right side of neck 1.30E+00 7.7E−03 1.10E−02 2.90E+00 5.70E−01 3.43E−01 4.76E−02 5.70E−01

Back of head 2.5E−03 7.7E−03 2.90E−01 2.90E−01 1.09E−02 3.43E−01 5.70E−01 5.70E−01

Front of neck 1.30E+00 7.7E−03 1.08E−01 1.08E−01 5.70E−01 3.43E−01 5.70E−01 5.70E−01

Back of neck 2.49E−02 7.7E−03 1.10E−02 1.10E−02 4.76E−02 2.87E−02 4.76E−02 4.76E−02

Front torso: base of neck to end of sternum 1.30E+00 2.46E−01 2.90E+00 2.90E+00 5.70E−01 3.43E−02 5.70E−01 5.70E−01

Front torso: end of sternum to lowest rib 1.30E+00 2.46E−01 2.90E+00 2.90E+00 8.E−04 5.E−04 8.E−04 8.E−04

Front torso: lowest rib to iliac crest 1.30E+00 2.46E−01 2.90E+00 2.90E+00 8.E−04 5.E−04 8.E−04 8.E−04

Front torso: iliac crest to pubis 1.30E−01 2.46E−02 2.90E−01 2.90E−01 3.E−04 2.E−04 3.E−04 3.E−04

Back torso: base of neck to mid–back 2.49E−02 2.46E−01 1.10E−02 1.10E−02 1.09E−02 3.43E−02 1.09E−02 1.09E−02

Back torso: mid–back to lowest rib 2.49E−02 2.46E−01 1.10E−02 1.10E−02 8.E−04 5.E−04 8.E−04 8.E−04

Back torso: lowest rib to iliac crest 2.49E−02 2.46E−01 1.10E−02 1.10E−02 8.E−04 5.E−04 8.E−04 8.E−04

Back torso: buttocks (Iliac crest and below) 2.5E−03 2.46E−02 1.1E−03 1.1E−03 3.E−04 2.E−04 3.E−04 3.E−04

Right torso: base of neck to end of sternum 1.30E+00 2.90E+00 1.10E−02 2.90E+00 5.70E−02 3.43E−01 5.70E−02 5.70E−02
ATTACHMENT B

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 0

6 Effective Date: 09/2

7/2019 Page 140 of 140

Area of skin

AP

thoracic 

spine

LAT

thoracic 

spine

RPO

thoracic 

spine

LPO

thoracic 

spine

AP

cervical 

spine

LAT

cervical 

spine

RPO

cervical 

spine

LPO

cervical 

spine

Right torso: end of sternum to lowest rib 1.30E+00 2.90E+00 1.10E−02 2.90E+00 8.E−04 5.E−04 8.E−04 8.E−04

Right torso: lowest rib to iliac crest 1.30E+00 2.90E+00 1.10E−02 2.90E+00 8.E−04 5.E−04 8.E−04 8.E−04

Right torso: iliac crest to pubis (right hip) 1.30E−01 2.90E−01 1.1E−03 2.90E−01 3.E−04 2.E−04 3.E−04 3.E−04

Left torso: base of neck to end of sternum 1.30E+00 1.10E−02 2.90E+00 1.10E−02 5.70E−02 1.3E−03 5.70E−02 5.70E−02

Left torso: end of sternum to lowest rib 1.30E+00 1.10E−02 2.90E+00 1.10E−02 8.E−04 5.E−04 8.E−04 8.E−04

Left torso: lowest rib to iliac crest 1.30E+00 1.10E−02 2.90E+00 1.10E−02 8.E−04 5.E−04 8.E−04 8.E−04

Left torso: iliac crest to pubis (Left hip) 1.30E−01 1.1E−03 2.90E−01 1.1E−03 3.E−04 2.E−04 3.E−04 3.E−04

a. Values less than 0.1 mrem shown to one significant digit.