Page 1 of 114

DOE Review Release 08/17/2018

Dose Reconstruction from Occupational 

Medical X-Ray Procedures

ORAUT-OTIB-0006 Rev. 05

Effective Date: 08/13/2018

Supersedes: Revision 04

Subject Expert(s): Robert C. Winslow

Document Owner 

Approval: Signature on File

Robert C. Winslow, Document Owner

Approval Date: 08/07/2018

Concurrence: Signature on File

John M. Byrne, Objective 1 Manager

Concurrence Date: 08/07/2018

Concurrence: Signature on File

Scott R. Siebert, Objective 3 Manager

Concurrence Date: 08/07/2018

Concurrence: Vickie S. Short Signature on File for

Kate Kimpan, Project Director

Concurrence Date: 08/07/2018

Approval: Signature on File

James W. Neton, Associate Director for Science

Approval Date: 08/13/2018

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. 05 Effective Date: 08/13/2018 Page 2 of 114

 

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 re-instate 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

06/20/2011 04 Revision to add organ dose data from lordotic and oblique chest Xrays, 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. 05 Effective Date: 08/13/2018 Page 3 of 114

 

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 B13 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 Reference 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.
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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 Substitute Dose Conversion Factors for Organs Not Listed in Publication 34 ............. 18

5.2 Dose Conversion Factors for Poor Collimation ........................................................... 20

6.0 Determining Dose Equivalent to Skin ..................................................................................... 23

6.1 Entrance Skin Dose Equivalent .................................................................................. 23

6.2 Exit Skin Dose Equivalent........................................................................................... 23

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............................................................................. 24

7.1 Radiographic Chest.................................................................................................... 25

7.2 Photofluorographic Chest ........................................................................................... 26

7.3 Chest Fluoroscopy...................................................................................................... 28

7.4 Lumbar Spine ............................................................................................................. 30

7.5 Pelvis.......................................................................................................................... 32

7.6 Thoracic and Cervical Spine....................................................................................... 33

8.0 Uncertainty Analysis for Occupational Medical X-Ray Doses ................................................. 36

9.0 X-Ray Dose Assignment by ICD-9 Code................................................................................ 38

10.0 Attributions and Annotations .................................................................................................. 39

References ........................................................................................................................................ 40

ATTACHMENT A SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES......................... 46

ATTACHMENT B ORGAN DOSE EQUIVALENT TABLES.......................................................... 86
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LIST OF TABLES

TABLE TITLE PAGE

3-1 Standard body dimensions, SIDs, and SSDs used for dose reconstruction............................ 13

3-2 Relationship of technical factors to X-ray beam output........................................................... 15

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

5-1 Organs without ICRP Publication 34 DCFs and their substitutes............................................ 20

5-2 DCFs for poorly collimated chest beams through 1970 .......................................................... 21

5-3 DCFs for poorly collimated spine and pelvis beams through 1970 ......................................... 22

7-1 Typical protocols for thoracic and cervical spine examinations............................................... 33

7-2 Relevant technical factors for cervical spine projections, HVL = 2.0 mm Al............................ 35

8-1 Adult body thickness from literature ....................................................................................... 38

A-1 Selection of organs for chest X-ray dose reconstruction based on ICD-9 code ...................... 47

A-2 Selection of organs for chest X-ray dose reconstruction based on ICD-9 code when 

different organ selection required based on view ................................................................... 78

A-3 Selection of organs for lumbar spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 84

A-4 Selection of organs for thoracic spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 84

A-5 Selection of organs for cervical spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 85

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

through 1970..........................................................................................................................87

B-2 DCFs used in determining dose equivalents for chest projections through 1985 .................... 88

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

lumbar spine and pelvis for all periods ................................................................................... 89

B-4 Skin dose guidance for chest projections for the poor collimation period through 1970.......... 90

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

period through 1970...............................................................................................................92

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

1970.......................................................................................................................................93

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

1970.......................................................................................................................................95

B-8 Skin dose guidance for chest projections for the good collimation period after 1970 .............. 96

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

1970.......................................................................................................................................97

B-10 Organ dose equivalents for chest projections for all periods................................................. 100

B-11 Skin dose equivalents from chest projections through 1970................................................. 103

B-12 Skin dose equivalents from various chest projections after 1970.......................................... 104

B-13 Organ dose equivalents for lumbar spine and pelvis projections for all periods .................... 106

B-14 Skin dose equivalent from lumbar spine and pelvis projections for all periods...................... 108

B-15 Organ dose equivalents for thoracic and cervical spine projections through 1970................ 110

B-16 Skin dose equivalent from thoracic and cervical spine projections through 1970.................. 113
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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 ...................................................................................... 27

7-2 Typical General Electric PFG system..................................................................................... 27

7-3 Diagram of non-image-intensified fluoroscopy........................................................................ 29

7-4 Beam areas in relation to body anatomy for the AP lumbar spine .......................................... 31

7-5 Beam areas in relation to body anatomy for the AP pelvis...................................................... 33

7-6 Beam areas in relation to body anatomy for the AP thoracic spine......................................... 34

7-7 Beam areas in relation to body anatomy for the LAT cervical spine ....................................... 36
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ACRONYMS AND ABBREVIATIONS

AP anterior-posterior

AWE atomic weapons employer

C coulomb

CFR Code of Federal Regulations

cGy centigray

cm centimeter

cSv centisievert

DAP dose area product

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

eq. equivalent

ENSD entrance skin dose

ESE entrance skin exposure

EXSD exit skin dose

Gy gray

HE effective dose equivalent

HVL half-value layer

ICD-9 International Classification of Diseases, Ninth Edition

ICRP International Commission on Radiological Protection

in. inch

IREP Interactive RadioEpidemiological Program

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

mrad millirad

mrem millirem

NCRP National Council on Radiation Protection and Measurements
Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 8 of 114

NIOSH National Institute for Occupational Safety and Health

OBL oblique

ORAU Oak Ridge Associated Universities

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. 05 Effective Date: 08/13/2018 Page 9 of 114

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.

The Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA) requires 

the assignment of external dose from medical X-ray examinations that were performed for 

occupational health screening and required as a condition of employment. According to 42 CFR 

Part 81, external doses from occupational X-ray screening procedures that were provided to the 

energy employee as a condition of employment must be included in dose reconstruction, while those 

performed for diagnostic or therapeutic reasons 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 radiation as the 

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

This interpretation affects the assignment of X-ray dose if the X-rays were taken at a site or location 

that is not defined under the statute as a covered facility, such as the noted offsite locations. Except 

in limited circumstances in relation to residual radiation, only radiation that the employee received at a 

covered facility can be included in 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 
Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 10 of 114

 

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.

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. 

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 

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 
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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 for radiographic 

installations, and 1 mm Al equivalent 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, thoracic, cervical spine, and pelvis

X-rays, 2.5 mm Al for most other 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: single-phase full-wave-rectified, typical of virtually all medical radiographic units used through 

the mid-1980s; three-phase; and 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 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 threephase 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 highfrequency 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.
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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 source-to-image distance (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-toskin 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. As a result, and 

because the organ dose conversion factors (DCFs) in International Commission on Radiological 

Protection (ICRP) Publication 34 (ICRP 1982) are based on standard body dimensions (Cahoon 

1961; Wochos, Detorie, and Cameron 1979; Kereiakes and Rosenstein 1980), dose reconstruction 

must be performed assuming the standard body dimensions.

Table 3-1 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 

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).
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Table 3-1. Standard body dimensions, SIDs, and SSDs used for dose reconstruction. 

Chest

Projection

Part thickness 

(cm)a

Standard SID 

(in/cm)b

Calculated SSD

(cm)c

PA (PFG) 24 40/102 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)a

Standard SID 

(in/cm)b

Calculated SSD

(cm)c

AP and spot 24 40/102 73

LAT and spot 34 40/102 63

Thoracic spine

Projection

Part thickness 

(cm)a

Standard SID 

(in/cm)b

Calculated SSD

(cm)c

AP 24 40/102 73

LAT 34 40/102 63

OBL 34 40/102 63

Cervical spine

Projection

Part thickness 

(cm)a

Standard SID 

(in/cm)b

Calculated SSD

(cm)c

AP 15 40/102 82

LAT 15 72/183d 153e

OBL 15 40/102 82

Pelvis

Projection

Part thickness 

(cm)a

Standard SID 

(in/cm)b

Calculated SSD

(cm)c

AP 24 40/102 73

a. 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.

b. Standard SID values from ICRP (1982), Tables A2 to A9.

c. 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.

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

e. 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.

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 

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 
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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 

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.
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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 dose per X-ray procedure generally shows a downward trend over this period. 

Grids are devices that are used 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 of the strips appearing 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. 

The effect of various technical factors on radiation output is listed in Table 3-2.

Table 3-2. 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 

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 

from a given machine. Unfortunately, X-ray beam measurements are often unavailable, particularly 
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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 3-2 and the standard SSDs from Table 3-1, 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 1 1 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-1 = 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 taken with the use of a phantom would 

not be appropriate to be used in the provided formula.

All information collected at 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 

provided from the sites would 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 mostly had to rely on the 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 3-1. The 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 3-1.

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 

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 
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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 0.10 4.0 0.05

LAT 2.5 0.50c 2.5 0.25 4.0 0.13

OBL 2.5 0.50d 2.5 0.25 4.0 0.13

AP lordotic 2.5 0.20e 2.5 0.10 4.0 0.05

Fluoroscopy

(PA)

2.5 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 2.00 cGy is for stereo (two-exposure) PFG (Kirklin et al. ca. 1969; Rising and Soldat 1959).

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

d. Chest Oblique assumed to have same Incident air kerma as Chest Lateral projection based on projection through a 

longer axis of the body.

e. Chest AP lordotic assumed to have same incident air kerma as Chest Posterior-Anterior.

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

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). 

i. Thoracic-Spine Oblique assumed to have same Incident air kerma as Thoracic-Spine Lateral projection based on 

projection through a longer axis of the body.

j. Source: Braestrup and Wycoff (1958, p. 81). 
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5.0 DETERMINING DOSE EQUIVALENT TO ORGANS OTHER THAN SKIN

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) will be used:

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

where

ODE = organ dose equivalent (rem) 

Ka,i = incident air kerma (cGy) 

DCF = selected 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 SUBSTITUTE DOSE CONVERSION FACTORS FOR ORGANS NOT LISTED IN 

PUBLICATION 34

Tables A2 to A8 in ICRP Publication 34 (ICRP 1982) do not include all the organs that correspond to 

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.
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Figure 5-1. Diagram of the torso (Beers 2003, Section 1, Chapter 1). 

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.
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Table 5-1. Organs without ICRP Publication 34 DCFs and 

their substitutes.a

External

organ 

ICRP 34 

substitute DCF

Thymus, 

Esophagus

Lung

Stomach, 

Bone surface, 

Liver/gallbladder/spleen, 

Small Intestine 

Remainder organs

Lungb or ovary

Urinary bladder, 

Colon/rectum, prostate

Ovary

Eye/brain Thyroid

a. Applies to most properly collimated radiographic procedures.

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

pelvis or lumbar spine. 

Attachment A, Table A-1 provides additional guidance for organ selection by International 

Classification of Diseases, Ninth Edition (ICD-9) code for dose assignment. 

5.2 DOSE CONVERSION FACTORS FOR POOR COLLIMATION

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 that 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. 
 

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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 skull Thyroid DCF for AP 

cervical spine

Ovaries Measuredb Ovaries DCF for PA 

Chest

Measuredb Measuredb AP abdomen DCF 

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 AP abdomen DCF

Colon/rectum Measuredb Ovaries DCF for PA Chest Measuredb Measuredb AP abdomen DCF 

Testes Measuredb Testes DCF for PA Chest Measuredb Measuredb AP abdomen DCF 

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 AP abdomen DCF 

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 PA 

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 

PA 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.
 

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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 DCF for LAT 

cervical spine

Thyroid DCF Thyroid DCF

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

DCFd

Thyroid DCF Thyroid DCF Thyroid DCF

Ovaries Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb Measuredb

Liver, gallbladder, spleen Ovary DCF Ovary DCF Ovary DCF Lungs male DCF Lung female DCF Lung DCF Lung DCF

Urinary Bladder/prostate Ovary DCF Ovary DCF Ovary DCF Ovary DCF Ovary DCF Measuredb Measuredb

Colon/rectum Ovary DCF Ovary DCF Ovary DCF Ovary DCF Ovary DCF 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 Ovary DCF Ovary DCF Ovary DCF Lungs male DCF Lung female DCF Lung DCF Lung DCF

Bone surfaces Ovary DCF Ovary DCF Ovary DCF Lungs male DCF Lung female DCF Lung DCF Lung DCF

Remainder Ovary DCF Ovary DCF Ovary DCF Lungs male DCF Lung female DCF Lung DCF Lung DCF

Breast Derivedc Derivedc Derivedc Breast DCF Breast DCF Lung DCF Lung DCF 

Uterus Uterus DCF Uterus DCF Uterus DCF Uterus DCF Uterus DCF Measured Measured

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 as provided in Table B-13 is used rather than a DCF.

c. Used method from Huda and Bissessur (1990).

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

(6-1) ( )( ) ( ) ( ) ( ) ( ) −

= 1 2

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

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 ignored (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

(formula 6-1 from Wall, Harrison, Spiers 1988, p.10 with modification for conversion to cSv)

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 

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

In this TIB, the standard body dimensions from Table 3-1 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) −

= 1EXSD ENSD AF 0.9

where

EXSD = exit skin dose

ENSD = ENSD

0.9 = uncertainty factor in the tabulated absorption factors

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

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 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. 
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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 

1991 (Thomas 1991b, p. 4) or at Brookhaven National Laboratory in 1994 (Bernacki 1994, pp. 13–14). 

These 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 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 a site’s 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 radiographic 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 the employee was employed. If the termination of 

employment is after the anniversary date (month and day) of the beginning employment, an additional 

termination X-ray procedure is assumed for that year and the dose assigned is 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). Doses from the OBL chest 

projection should be included in dose reconstructions for asbestos workers if they are listed in the 

worker’s claim file as having been performed. 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, with the exception of skin, which is different from those of the 

LAT chest projection because of the beam entering on the left side of the body (for the RAO) rather 

than the right side (for the LAT).

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 
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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 

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 preemployment examination should be included in dose 

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

may be considered a diagnostic projection in accordance with the definition of screening and not be 

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

7.2 PHOTOFLUOROGRAPHIC CHEST

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 a photograph of a General 

Electric PFG machine.
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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). 

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 per mm 

(Goodwin, Quimby, and Morgan 1970, p. 108). In addition, the small size of the 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 
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recommended, “Whenever possible, Federal agencies should not use photofluorographic equipment 

to perform X-ray examinations” (EPA 1976, p. 19). 

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 

distance of 40 in. and 2.4 mm added filtration. 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) 

As a result of the shorter SID of PFG in comparison with conventional radiographic machines, the 

beam for PFG is estimated 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.

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. Dose 

reconstructors must pay attention to the size of the film in the claim file records and, if the 4- by 10-in. 

film is noted to have been used, should assume stereo projections and use 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., dose 

reconstructors should assume a single projection and divide the organ doses in Tables B-10 and B-11

in half. 

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.

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 preemployment screening of workers, and it was not mentioned as a screening technique in a 

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. 
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Although chest fluoroscopy was not a standard preemployment 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 performed in the modern era, additional conservativism regarding 

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 X-ray field is assumed to include the 

thoracic organs and the liver/gallbladder/spleen, but it does not include the thyroid, gonads, urinary 

bladder/prostate, or colon/rectum because of the short SSD (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, and doses for chest fluoroscopy are included in Tables B-10 and B-11 in 

Attachment B. 

Figure 7-3. Diagram of non-image-intensified 

fluoroscopy (Massey 1977, p. 90). 
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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 preemployment 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 (see Tables B-13 and B-14). The organ 

dose equivalents for the individual projections are provided. 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 preemployment 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).

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 used (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 

low kilovoltage techniques conducted in London (Stanford and Vance 1955). Values for the same 

projections using high voltage techniques are 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 since 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 the lumbar spine projections through 1970 were 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.
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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 and properly 

collimated beams in relation to abdominal organs for the AP lumbar spine and helps to visualize the 

beam for the proper selection of DCFs. The ovary DCF from ICRP Publication 34 (ICRP 1982) 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 DCFs are summarized in Table B-3. 

Figure 7-4. Beam areas in relation to body anatomy for 

the AP lumbar spine (modified from Beers 2003, [p. 4]). 

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. 

Again, the ovary DCF from ICRP Publication 34 (ICRP 1982) 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.

There is no DCF in ICRP Publication 34 (ICRP 1982) for the breast from lumbar spine projections. 

Publication 34 (p. 34) states that the DCF is “not computed but small compared with projections 

listed.” Several methods of estimating breast dose equivalent have been used in some of the site 

profiles. In this TIB, a method from Huda and Bissessur (1990) was used to determine the dose 

equivalent to the breast from the lumbar spine projections. Huda and Bissessur provide graphical 

representations of the effective dose equivalent (HE in Huda and Bissessur) per unit ENSD

(backscatter included) as a function of kVp for 12 common radiographic procedures along with values 

of dose equivalent per unit dose area product (DAP). The data are a result of individual organ doses 

that were obtained using a Monte Carlo method for Reference Man as a function of kVp and X-ray 
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beam filtration (Huda and Bissessur 1990, p. 2). Huda and Bissessur provide the fraction of the total 

HE due to several organs, one of which is the breast. With knowledge of the DAP, and the fraction 

due to the breast dose, the HE and the dose to the breast can be derived (Huda and Bissessur 1990, 

p. 5). The dose to the breast from lumbar spine projections for both periods was determined using 

this method.

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 Xrays of the pelvis 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 described in the site profiles for those 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 if the employees’ 

records include evidence of these types of X-ray procedures. 

Lincoln and Gupton (1958) measured skin and gonad doses (including backscatter) using a tissueequivalent phantom for various examinations including the AP pelvis. Lincoln and Gupton (1958, 

Table V) provides dose information for X-ray examination of the pelvis from some facilities and other 

literature. 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 Lincoln 

and Gupton (1958, Table VII) were used based on the measurements being performed at ORNL with 

techniques and filtration assumed to be similar to those used 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 for 

the proper selection of DCFs. The ovary DCF from ICRP Publication 34 (ICRP 1982) 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 DCFs are summarized in Table B-3. 
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Figure 7-5. Beam areas in relation to body anatomy for 

the AP pelvis (modified from Beers 2003, [p. 4]). 

There is no DCF in ICRP Publication 34 (ICRP 1982) for the breast from the AP pelvis. Publication 34 

(p. 34) states that the DCF is “not computed but small compared with projections listed.” The method 

described by Huda and Bissessur (1990) in Section 7.4 was used to determine the dose to the breast 

from the AP pelvis. 

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. 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 if the employees’ records include evidence of these types of X-ray 

procedures. 

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. 

Procedure Projections

Thoracic spine AP, LAT, RPO, LPO, total of four.

Cervical spine AP, LAT, RPO, LPO, total of four.
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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 (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 poorly collimated beam. The thyroid is assumed to be in the poorly 

collimated beam but not the eye/brain, the dose to which is usually 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 ovary DCF because these organs are 

all assumed to be outside the poorly collimated beam. 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.
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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 3-1. 

d. Based on kVp and 2.5 mm Al equivalent 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 actual mAs 2.58 10 C/kg R 33.97J/C 100cGy/Gy 1Gy/1J kg SID K R

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 

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 equivalent total filtration from Braestrup and Wyckoff (1958, Table VI). 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.
Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 36 of 114

 

Figure 7-7. Beam areas in relation to body anatomy for the 

LAT cervical spine (modified from Beers 2003, [p. 3]). 

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. 

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. 

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 (reproducibility of the measurement) and accuracy (how 

close the measurement or estimate of dose comes to the actual or correct value).
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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). 

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 Loevenger 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 
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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). 

Table 8.1. Adult body thickness from literature. 

Thorax/Abdomen

AP Thickness 

(cm)

Thorax/Abdomen

Lateral Thickness 

(cm)

Neck

Cervical Vertebrae

AP Thickness 

(cm)

Neck

Cervical Vertebrae

Lateral Thickness 

(cm) Reference

Thor. Vert. 20-24

Lumb. Vert. 18-22

Pelvis 19-23

Chest 20-25

Thor. Vert. 28-32

Lumb. Vert. 37-32

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

There are two approaches to determine the combined uncertainty from these five potential sources of 

uncertainty. The first, and most conservative in that it gives the greatest range, is to assume that the 

uncertainties are additive, which would give an uncertainty range of 2 + 9 +5 + 25 + 10 = ±51%. 

However, a more 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, which is ±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-9 CODE

Under the EEOICPA, the organs and tissues for which doses must be estimated are those that are 

delineated by the specified ICD-9 code that is received from the U.S. Department of Labor (DOL). 

While many ICD-9 codes are clear in their intended organ or tissue, additional guidance is necessary 

to identify the appropriate organs or tissues for X-ray dose estimation. 

Attachment B provides guidance for X-ray dose assignment based on skin cancer location. 

Attachment A provides guidance by ICD-9 code for the various X-ray views in this TIB. For some 

ICD-9 codes that cover a large portion 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-9 codes to allow for a more appropriate assignment of dose. For claims in which the specific 
Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 39 of 114

 

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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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 Laboratory), 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 

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Administration, San Francisco, California. [SRDB Ref ID: 13881]

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109, pp. 25–27. [SRDB Ref ID: 11321]

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ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES

LIST OF TABLES

TABLE TITLE PAGE

A-1 Selection of organs for chest X-ray dose reconstruction based on ICD-9 code ...................... 47

A-2 Selection of organs for chest X-ray dose reconstruction based on ICD-9 code when 

different organ selection required based on view ................................................................... 78

A-3 Selection of organs for lumbar spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 84

A-4 Selection of organs for thoracic spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 84

A-5 Selection of organs for cervical spine X-ray dose reconstruction based on ICD-9 code 

when different organ selection required based on view .......................................................... 85
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 47 of 114

Table A-1. Selection of organs for chest X-ray dose reconstruction based on ICD-9 code.

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

140 Malig neoplasm lip See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

140.0 Malig neo upper vermilion See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.1 Malig neo lower vermilion See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.3 Malig neo upper lip, inner See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.4 Malig neo lower lip, inner See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.5 Malig neo lip, inner nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.6 Malig neo lip, commissure See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.8 Malig neo lip nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

140.9 Malig neo lip/vermil nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

141 Malig neo tongue See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

141.0 Malig neo tongue base Thyroid Thyroid Thyroid Thyroid Thyroid

141.1 Malig neo dorsal tongue Thyroid Thyroid Thyroid Thyroid Thyroid

141.2 Malig neo tip/lat tongue Thyroid Thyroid Thyroid Thyroid Thyroid

141.3 Malig neo ventral tongue Thyroid Thyroid Thyroid Thyroid Thyroid

141.4 Malig neo ant 2/3 tongue Thyroid Thyroid Thyroid Thyroid Thyroid

141.5 Malig neo tongue junction Thyroid Thyroid Thyroid Thyroid Thyroid

141.6 Malig neo lingual tonsil Esophagus Esophagus Esophagus Esophagus Esophagus

141.8 Malig neo tongue nec Thyroid Thyroid Thyroid Thyroid Thyroid

141.9 Malig neo tongue nos Thyroid Thyroid Thyroid Thyroid Thyroid

142 Malig neo major salivary See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

142.0 Malig neo parotid Thyroid Thyroid Thyroid Thyroid Thyroid

142.1 Malig neo submandibular Thyroid Thyroid Thyroid Thyroid Thyroid

142.2 Malig neo sublingual Thyroid Thyroid Thyroid Thyroid Thyroid

142.8 Malig neo maj salivary nec Thyroid Thyroid Thyroid Thyroid Thyroid

142.9 Malig neo salivary nos Thyroid Thyroid Thyroid Thyroid Thyroid

143 Malignant neoplasm gum See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

143.0 Malig neo upper gum Thyroid Thyroid Thyroid Thyroid Thyroid
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 48 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

143.1 Malig neo lower gum Thyroid Thyroid Thyroid Thyroid Thyroid

143.8 Malig neo gum nec Thyroid Thyroid Thyroid Thyroid Thyroid

143.9 Malig neo gum nos Thyroid Thyroid Thyroid Thyroid Thyroid

144 Malig neo mouth floor See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

144.1 Malig neo lat floor mouth Thyroid Thyroid Thyroid Thyroid Thyroid

144.8 Malig neo mouth floor nec Thyroid Thyroid Thyroid Thyroid Thyroid

144.9 Malig neo mouth floor nos Thyroid Thyroid Thyroid Thyroid Thyroid

145 Malig neo mouth nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

145.0 Malig neo cheek mucosa Thyroid Thyroid Thyroid Thyroid Thyroid

145.1 Malig neo mouth vestibule Thyroid Thyroid Thyroid Thyroid Thyroid

145.2 Malig neo hard palate Thyroid Thyroid Thyroid Thyroid Thyroid

145.3 Malig neo soft palate Thyroid Thyroid Thyroid Thyroid Thyroid

145.4 Malig neo uvula Thyroid Thyroid Thyroid Thyroid Thyroid

145.5 Malig neo palate nos Thyroid Thyroid Thyroid Thyroid Thyroid

145.6 Malig neo retromolar Thyroid Thyroid Thyroid Thyroid Thyroid

145.8 Malig neo mouth nec Thyroid Thyroid Thyroid Thyroid Thyroid

145.9 Malig neo mouth nos Thyroid Thyroid Thyroid Thyroid Thyroid

146 Malig neo oropharynx See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

146.0 Malig neo tonsil Esophagus Esophagus Esophagus Esophagus Esophagus

146.1 Malig neo tonsillar fossa Esophagus Esophagus Esophagus Esophagus Esophagus

146.2 Malig neo tonsil pillars Esophagus Esophagus Esophagus Esophagus Esophagus

146.3 Malig neo vallecula Thyroid Thyroid Thyroid Thyroid Thyroid

146.4 Malig neo ant epiglottis Thyroid Thyroid Thyroid Thyroid Thyroid

146.5 Malig neo epiglottis junct Thyroid Thyroid Thyroid Thyroid Thyroid

146.6 Malig neo lat oropharynx Thyroid Thyroid Thyroid Thyroid Thyroid

146.7 Malig neo post oropharynx Thyroid Thyroid Thyroid Thyroid Thyroid

146.8 Malig neo oropharynx nec Thyroid Thyroid Thyroid Thyroid Thyroid

146.9 Malig neo oropharynx nos Thyroid Thyroid Thyroid Thyroid Thyroid

147 Malig neo nasopharynx See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

147.0 Malig neo super nasopharyn Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

147.1 Malig neo post nasopharynx Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

147.2 Malig neo lat nasopharynx Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

147.3 Malig neo ant nasopharynx Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

147.8 Malig neo nasopharynx nec Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

147.9 Malig neo nasopharynx nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

148 Malig neo hypopharynx See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 49 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

148.0 Malig neo postcricoid Thyroid Thyroid Thyroid Thyroid Thyroid

148.1 Malig neo pyriform sinus Thyroid Thyroid Thyroid Thyroid Thyroid

148.2 Malig neo aryepiglott fold Thyroid Thyroid Thyroid Thyroid Thyroid

148.3 Malig neo post hypopharynx Thyroid Thyroid Thyroid Thyroid Thyroid

148.8 Malig neo hypopharynx nec Thyroid Thyroid Thyroid Thyroid Thyroid

148.9 Malig neo hypopharynx nos Thyroid Thyroid Thyroid Thyroid Thyroid

149 Other malig oropharynx See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

149.0 Malig neo pharynx nos Thyroid Thyroid Thyroid Thyroid Thyroid

149.1 Malig neo waldeyer’s ring Thyroid Thyroid Thyroid Thyroid Thyroid

149.8 Malig neo oral/pharynx nec Thyroid Thyroid Thyroid Thyroid Thyroid

149.9 Malig neo orophryn ill-def Thyroid Thyroid Thyroid Thyroid Thyroid

150 Malig neo esophagus See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

150.0 Malig neo cervical esophag Esophagus Esophagus Esophagus Esophagus Esophagus

150.1 Malig neo thoracic esophag Esophagus Esophagus Esophagus Esophagus Esophagus

150.2a Malig neo abdomin esophag Esophagus Esophagus or 

Stomacha

Esophagus Esophagus Esophagus or 

Stomacha

150.3 Malig neo upper 3rd esoph Esophagus Esophagus Esophagus Esophagus Esophagus

150.4 Malig neo middle 3rd esoph Esophagus Esophagus Esophagus Esophagus Esophagus

150.5a Malig neo lower 3rd esoph Esophagus Esophagus or 

Stomacha

Esophagus Esophagus Esophagus or 

Stomacha

150.8a Malig neo esophagus nec Esophagus Esophagus or 

Stomacha

Esophagus Esophagus Esophagus or 

Stomacha

150.9 Malig neo esophagus nos Esophagus Esophagus Esophagus Esophagus Esophagus

151 Malignant neo stomach See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

151.0 Malig neo stomach cardia Stomach Stomach Stomach Stomach Stomach

151.1 Malig neo pylorus Stomach Stomach Stomach Stomach Stomach

151.2 Malig neo pyloric antrum Stomach Stomach Stomach Stomach Stomach

151.3 Malig neo stomach fundus Stomach Stomach Stomach Stomach Stomach

151.4 Malig neo stomach body Stomach Stomach Stomach Stomach Stomach

151.5 Malig neo stom lesser curv Stomach Stomach Stomach Stomach Stomach

151.6 Malig neo stom great curv Stomach Stomach Stomach Stomach Stomach

151.8 Malig neo stomach nec Stomach Stomach Stomach Stomach Stomach

151.9 Malig neo stomach nos Stomach Stomach Stomach Stomach Stomach

152 Malig neo small bowel See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

152.0 Malig neo duodenum Stomach Stomach Stomach Stomach Stomach

152.1 Malig neo jejunum Stomach Stomach Stomach Stomach Stomach
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 50 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

152.2 Malig neo ileum Colon Colon Colon Colon Colon

152.3 Malig neo meckel’s divert Colon Colon Colon Colon Colon

152.8 Malig neo small bowel nec Stomach Stomach Stomach Stomach Stomach

152.9 Malig neo small bowel nos Stomach Stomach Stomach Stomach Stomach

153 Malignant neoplasm colon See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

153.0 Malig neo hepatic flexure Stomach Stomach Stomach Stomach Stomach

153.1 Malig neo transverse colon Stomach Stomach Stomach Stomach Stomach

153.2 Malig neo descend colon Stomach Stomach Stomach Stomach Stomach

153.3 Malig neo sigmoid colon Stomach Colon Colon Colon Colon

153.4 Malig neo cecum Colon Colon Colon Colon Colon

153.5 Malig neo appendix Colon Colon Colon Colon Colon

153.6 Malig neo ascend colon Colon Stomach Stomach Stomach Stomach

153.7 Malig neo splenic flexure Stomach Stomach Stomach Stomach Stomach

153.8 Malig neo colon nec Stomach Colon Stomach Stomach Stomach

153.9 Malig neo colon nos Stomach Colon Stomach Stomach Stomach

154 Malig neo rectum/anus See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

154.0 Malig neo rectosigmoid jct Colon Colon Colon Colon Colon

154.1 Malig neo rectum Colon Colon Colon Colon Colon

154.2 Malig neo anal canal Colon Colon Colon Colon Colon

154.3 Malig neo anus nos Colon Colon Colon Colon Colon

154.8 Malig neo rectum/anus nec Colon Colon Colon Colon Colon

155 Malignant neoplasm liver See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

155.0 Malig neo liver, primary Liver Liver Liver Liver Liver

155.1 Malig neo intrahepat ducts Liver Liver Liver Liver Liver

155.2 Malig neo liver nos Liver Liver Liver Liver Liver

156 Malig neo gb/extrahepatic See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

156.0 Malig neo gallbladder Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

156.1 Malig neo extrahepat ducts Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

156.2 Malig neo ampulla vater Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

156.8 Malig neo biliary nec Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

156.9 Malig neo biliary nos Gallbladder Gallbladder Gallbladder Gallbladder Gallbladder

157 Malignant neo pancreas See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

157.0 Malig neo pancreas head Liver Liver Liver Liver Liver

157.1 Malig neo pancreas body Liver Liver Liver Liver Liver

157.2 Malig neo pancreas tail Liver Liver Liver Liver Liver

157.3 Malig neo pancreatic duct Liver Liver Liver Liver Liver
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 51 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

157.4 Malig neo islet langerhans Liver Liver Liver Liver Liver

157.8 Malig neo pancreas nec Liver Liver Liver Liver Liver

157.9 Malig neo pancreas nos Liver Liver Liver Liver Liver

158 Malig neo peritoneum See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

158.0 Malig neo retroperitoneum Stomach Stomach Stomach Stomach Stomach

158.8 Malig neo peritoneum nec Stomach Stomach Stomach Stomach Stomach

158.9 Malig neo peritoneum nos Stomach Stomach Stomach Stomach Stomach

159 Other malig neo gi/periton See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

159.0 Malig neo intestine nos Stomach Stomach Stomach Stomach Stomach

159.1 Malig neo spleen nec Spleen Spleen Spleen Spleen Spleen

159.8 Malig neo gi/intra-abd nec Stomach Stomach Stomach Stomach Stomach

159.9 Malig neo gi tract ill-def Stomach Stomach Stomach Stomach Stomach

160 Malig neo nasal cav/sinus See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

160.0 Malig neo nasal cavities Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.1 Malig neo middle ear Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.2 Malig neo maxillary sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.3 Malig neo ethmoidal sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.4 Malig neo frontal sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.5 Malig neo sphenoid sinus Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.8 Malig neo access sinus nec Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

160.9 Malig neo access sinus nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

161 Malignant neo larynx See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

161.0 Malig neo glottis Thyroid Thyroid Thyroid Thyroid Thyroid

161.1 Malig neo supraglottis Thyroid Thyroid Thyroid Thyroid Thyroid

161.2 Malig neo subglottis Thyroid Thyroid Thyroid Thyroid Thyroid

161.3 Malig neo cartilage larynx Thyroid Thyroid Thyroid Thyroid Thyroid

161.8 Malig neo larynx nec Thyroid Thyroid Thyroid Thyroid Thyroid

161.9 Malig neo larynx nos Thyroid Thyroid Thyroid Thyroid Thyroid

162 Malig neo trachea/lung See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

162.0 Malig neo trachea Lung Lung Lung Lung Lung

162.2 Malig neo main bronchus Lung Lung Lung Lung Lung

162.3 Malig neo upper lobe lung Lung Lung Lung Lung Lung

162.4 Malig neo middle lobe lung Lung Lung Lung Lung Lung

162.5 Malig neo lower lobe lung Lung Lung Lung Lung Lung

162.8 Malig neo bronch/lung nec Lung Lung Lung Lung Lung

162.9 Malig neo bronch/lung nos Lung Lung Lung Lung Lung
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 52 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

163 Malignant neopl pleura See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

163.0 Malig neo parietal pleura Lung Lung Lung Lung Lung

163.1 Malig neo visceral pleura Lung Lung Lung Lung Lung

163.8 Malig neo pleura nec Lung Lung Lung Lung Lung

163.9 Malig neo pleura nos Lung Lung Lung Lung Lung

164 Malig neo thymus/mediastin See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

164.0 Malig neo thymus Thymus Thymus Thymus Thymus Thymus

164.1 Malig neo heart Thymus Thymus Thymus Thymus Thymus

164.2 Malig neo ant mediastinum Lung Lung Lung Lung Lung

164.3 Malig neo post mediastinum Lung Lung Lung Lung Lung

164.8 Malig neo mediastinum nec Lung Lung Lung Lung Lung

164.9 Malig neo mediastinum nos Lung Lung Lung Lung Lung

165 Oth/ill-def mal neo resp See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

165.0 Malig neo upper resp nos Lung Lung Lung Lung Lung

165.8 Malig neo thorax/resp nec Lung Lung Lung Lung Lung

165.9 Malig neo resp system nos Lung Lung Lung Lung Lung

170 Malig neo bone/artic cart See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

170.0 Malig neo skull/face bone Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

170.1 Malig neo mandible Thyroid Thyroid Thyroid Thyroid Thyroid

170.2 Malig neo vertebrae Bone Surface Bone Surface Bone Surface Bone Surface Bone Surface

170.3 Malig neo ribs/stern/clav Bone Surface Lungs Bone Surface Bone Surface Lung

170.4 Malig neo long bones arm See Tables B-4 

and B-8

See Table A-5 See Table B-6 See Table B-7 10% ENSD

170.5 Malig neo bones wrist/hand See Tables B-4 

and B-8

See Table A-5 10% ENSD RSD (0.40m) ENSD

170.6 Malig neo pelvic girdle Colon Bone Surface Bone Surface Bone Surface Bone Surface

170.7 Malig neo long bones leg RSD 10% ENSD RSD RSD 10% ENSD

170.8 Malig neo bones ankle/foot RSD RSD RSD RSD RSD (0.60 m)

170.9 Malig neo bone nos Bone Surface Bone Surface Bone Surface Bone Surface Bone Surface

171 Malig neo soft tissue See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

171.0 Malig neo soft tissue head See Tables B-4 

and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

171.2 Malig neo soft tissue arm See Tables B-4

and B-8

See Table A-3 See Table B-6 See Table B-7 See Table B-5

171.3 Malig neo soft tissue leg RSD 10% ENSD RSD (0.52) RSD (0.70) 10% ENSD

171.4 Malig neo soft tis thorax Remainder Remainder See Table A-4 See Table A-5 Lung
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 53 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

171.5 Malig neo soft tis abdomen Remainder Remainder See Table A-4 Remainder ENSD

171.6 Malig neo soft tis pelvis Colon Colon Colon Colon ENSD

171.7 Malig neo trunk nos Remainder Remainder See Table A-4 See Table A-5 ENSD

171.8 Malig neo soft tissue nec Remainder Remainder See Table A-4 See Table A-5 ENSD

171.9 Malig neo soft tissue nos Remainder Remainder See Table A-4 See Table A-5 ENSD

172 Malignant melanoma skin See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

172.0 Malig melanoma lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.1 Malig melanoma eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.2 Malig melanoma ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.3 Malig melanoma face nec/nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.4 Malig melanoma scalp/neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.5 Malig melanoma trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.6 Malig melanoma arm See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.7 Malig melanoma leg See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.8 Malig melanoma skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

172.9 Malig melanoma skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173 Other malig neopl skin See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.0 Malig neo skin lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.00 Unspecified malig neo skin lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.01 BCC skin lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.02 SCC skin lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 54 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

173.09 Other specified malig neo skin lip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.10 Malig neo eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.1 Unspecified malig neo eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.11 BCC skin eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.12 SCC skin eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.19 Other specified malig neo eyelid See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.2 Malig neo skin ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.20 Unspecified malig neo skin ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.21 BCC skin ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.22 SCC skin ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.29 Other specified malig neo skin ear See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.3 Malig neo skin face nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.30 Unspecified malig neo skin face nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.31 BCC skin face nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.32 SCC skin face nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.39 Other specified malig neo skin face nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.4 Malig neo scalp/skin neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.40 Unspecified malig neo scalp/skin neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 55 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

173.41 BCC skin scalp/skin neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.42 SCC skin scalp/skin neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.49 Other specified malig neo scalp/skin neck See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.5 Malig neo skin trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.50 Unspecified malig neo skin trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.51 BCC skin trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.52 SCC skin trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.59 Other specified malig neo skin trunk See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.6 Malig neo skin upper limb, incl shoulder See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.60 Unspecified malig neo skin upper limb, incl 

shoulder

See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.61 BCC skin upper limb, incl shoulder See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.62 SCC skin upper limb, incl shoulder See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.69 Other specified malig neo skin upper limb, 

incl shoulder

See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.7 Malig neo skin lower limb, incl hip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.70 Unspecified malig neo skin lower limb, incl 

hip

See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.71 BCC skin lower limb, incl hip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.72 SCC skin lower limb, incl hip See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.79 Other specified malig neo skin lower limb, 

incl hip

See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 56 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

173.8 Malig neo skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.80 Unspecified malig neo skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.81 BCC skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.82 SCC skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.89 Other specified malig neo skin nec See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.9 Malig neo skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.90 Unspecified malig neo skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.91 BCC skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.92 SCC skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

173.99 Other specified malig neo skin nos See Tables B-4 

and B-8

See Table B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

174 Malig neo female breast See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

174.0 Malig neo nipple Breast Breast Breast Breast Breast

174.1 Malig neo breast-central Breast Breast Breast Breast Breast

174.2 Malig neo breast up-inner Breast Breast Breast Breast Breast

174.3 Malig neo breast low-inner Breast Breast Breast Breast Breast

174.4 Malig neo breast up-outer Breast Breast Breast Breast Breast

174.5 Malig neo breast low-outer Breast Breast Breast Breast Breast

174.6 Malig neo breast-axillary Breast Breast Breast Breast Breast

174.8 Malig neo breast nec Breast Breast Breast Breast Breast

174.9 Malig neo breast nos Breast Breast Breast Breast Breast

175 Malig neo male breast See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

175.0 Malig neo male nipple Breast Breast Breast Breast Breast

175.9 Malig neo male breast nec Breast Breast Breast Breast Breast

176 Kaposi’s sarcoma See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

176.0 Skin-kaposi’s sarcoma See Tables B-4

and B-8

See Table B-5

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 57 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

176.1 Soft tissue-kaposi’s sarcoma Remainder Remainder Remainder Remainder Remainder

176.2 Palate-kaposi’s sarcoma Thyroid Thyroid Thyroid Thyroid Thyroid

176.3 Gi sites-kaposi’s sarcoma Stomach Stomach Stomach Stomach Stomach

176.4 Lung-kaposi’s sarcoma Lung Lung Lung Lung Lung

176.5 Lymph nodes-kaposi’s sarcoma Remainder Remainder Remainder Remainder Remainder

176.8 Spf sts-kaposi’s sarcoma Remainder Remainder Remainder Remainder Remainder

176.9 Kaposi’s sarcoma nos Remainder Remainder Remainder Remainder Remainder

179 Malig neo uterus nos Uterus Uterus Uterus Uterus Uterus

180 Malig neo cervix uteri See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

180.0 Malig neo endocervix Uterus Uterus Uterus Uterus Uterus

180.1 Malig neo exocervix Uterus Uterus Uterus Uterus Uterus

180.8 Malig neo cervix nec Uterus Uterus Uterus Uterus Uterus

180.9 Malig neo cervix uteri nos Uterus Uterus Uterus Uterus Uterus

181 Malig neo placenta Uterus Uterus Uterus Uterus Uterus

182 Malig neo uterus body See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

182.0 Malig neo corpus uteri Uterus Uterus Uterus Uterus Uterus

182.1 Malig neo uterine isthmus Uterus Uterus Uterus Uterus Uterus

182.8 Malig neo body uterus nec Uterus Uterus Uterus Uterus Uterus

183 Malig neo uterine adnexa See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

183.0 Malig neo ovary Ovaries Ovaries Ovaries Ovaries Ovaries

183.2 Malig neo fallopian tube Ovaries Ovaries Ovaries Ovaries Ovaries

183.3 Malig neo broad ligament Ovaries Ovaries Ovaries Ovaries Ovaries

183.4 Malig neo parametrium Ovaries Ovaries Ovaries Ovaries Ovaries

183.5 Malig neo round ligament Ovaries Ovaries Ovaries Ovaries Ovaries

183.8 Malig neo adnexa nec Ovaries Ovaries Ovaries Ovaries Ovaries

183.9 Malig neo adnexa nos Ovaries Ovaries Ovaries Ovaries Ovaries

184 Malig neo fem gen nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

184.0 Malig neo vagina Uterus Uterus Uterus Uterus Uterus

184.1 Malig neo labia majora Uterus Uterus Uterus Uterus Uterus

184.2 Malig neo labia minora Uterus Uterus Uterus Uterus Uterus

184.3 Malig neo clitoris Uterus Uterus Uterus Uterus Uterus

184.4 Malig neo vulva nos Uterus Uterus Uterus Uterus Uterus

184.8 Malig neo female genit nec Uterus Uterus Uterus Uterus Uterus

184.9 Malig neo female genit nos Uterus Uterus Uterus Uterus Uterus

185 Malig neo prostate Bladder Bladder Bladder Bladder Bladder

186 Malig neo testis See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 58 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

186.0 Malig neo undescend testis Testes Testes Testes Testes Testes

186.9 Malig neo testis nec Testes Testes Testes Testes Testes

187 Malig neo male genital nec See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

187.1 Malig neo prepuce Testes Testes Testes Testes Testes

187.2 Malig neo glans penis Testes Testes Testes Testes Testes

187.3 Malig neo penis body Testes Testes Testes Testes Testes

187.4 Malig neo penis nos Testes Testes Testes Testes Testes

187.5 Malig neo epididymis Testes Testes Testes Testes Testes

187.6 Malig neo spermatic cord Testes Testes Testes Testes Testes

187.7 Malig neo scrotum Testes Testes Testes Testes Testes

187.8 Malig neo male genital nec Testes Testes Testes Testes Testes

187.9 Malig neo male genital nos Testes Testes Testes Testes Testes

188 Malig neo bladder See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

188.0 Malig neo bladder-trigone Bladder Bladder Bladder Bladder Bladder

188.1 Malig neo bladder-dome Bladder Bladder Bladder Bladder Bladder

188.2 Malig neo bladder-lateral Bladder Bladder Bladder Bladder Bladder

188.3 Malig neo bladder-anterior Bladder Bladder Bladder Bladder Bladder

188.4 Malig neo bladder-post Bladder Bladder Bladder Bladder Bladder

188.5 Malig neo bladder neck Bladder Bladder Bladder Bladder Bladder

188.6 Malig neo ureteric orifice Bladder Bladder Bladder Bladder Bladder

188.7 Malig neo urachus Bladder Bladder Bladder Bladder Bladder

188.8 Malig neo bladder nec Bladder Bladder Bladder Bladder Bladder

188.9 Malig neo bladder nos Bladder Bladder Bladder Bladder Bladder

189 Malig neo urinary nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

189.0 Malig neo kidney Liver Liver Liver Liver Liver

189.1 Malig neo renal pelvis Liver Liver Liver Liver Liver

189.2 Malig neo ureter Liver Liver Liver Liver Liver

189.3 Malig neo urethra Bladder Bladder Bladder Bladder Bladder

189.4 Malig neo paraurethral Bladder Bladder Bladder Bladder Bladder

189.8 Malig neo urinary nec Liver Liver Liver Liver Liver

189.9 Malig neo urinary nos Liver Liver Liver Liver Liver

190 Malig neoplasm eye See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

190.0 Malig neo eyeball Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.1 Malig neo orbit Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.2 Malig neo lacrimal gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.3 Malig neo conjunctiva Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 59 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

190.4 Malig neo cornea Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.5 Malig neo retina Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.6 Malig neo choroid Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.7 Malig neo lacrimal duct Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.8 Malig neo eye nec Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

190.9 Malig neo eye nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191 Malig neoasm brain See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

191.0 Malig neo cerebrum Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.1 Malig neo frontal lobe Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.2 Malig neo temporal lobe Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.3 Malig neo parietal lobe Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.4 Malig neo occipital lobe Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.5 Malig neo cereb ventricle Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.6 Malig neo cerebellum nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.7 Malig neo brain stem Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.8 Malig neo brain nec Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

191.9 Malig neo brain nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

192 Malig neo nerve nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

192.0 Malig neo cranial nerves Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

192.1 Malig neo cerebral mening Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

192.2 Malig neo spinal cord Remainder Remainder Remainder Eye/brain Remainder

192.3 Malig neo spinal meninges Remainder Remainder Remainder Eye/brain Remainder

192.8 Malig neo nervous syst nec Remainder Remainder Remainder Eye/brain Remainder

192.9 Malig neo nervous syst nos Remainder Remainder Remainder Eye/brain Remainder

193 Malig neo thyroid Thyroid Thyroid Thyroid Thyroid Thyroid

194 Malig neo other endocrine See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

194.0 Malig neo adrenal Remainder Remainder Remainder Remainder Remainder

194.1 Malig neo parathyroid Thyroid Thyroid Thyroid Thyroid Thyroid

194.3 Malig neo pituitary Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

194.4 Malig neo pineal gland Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

194.5 Malig neo carotid body Thyroid Thyroid Thyroid Thyroid Thyroid

194.6 Malig neo paraganglia nec Remainder Remainder Remainder Eye/brain Remainder

194.8 Malig neo endocrine nec Remainder Remainder Remainder Eye/brain Remainder

194.9 Malig neo endocrine nos Remainder Remainder Remainder Eye/brain Remainder

195 Malig neo head/face/neck See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

195.0 Malig neo oth/ill-def site Eye/brain Eye/brain Thyroid Thyroid Eye/brain
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 60 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

195.1 Malig neo thorax Remainder Remainder Remainder Remainder Remainder

195.2 Malig neo abdomen Remainder Remainder Remainder Remainder ENSD

195.3 Malig neo pelvis Remainder Remainder Remainder Remainder ENSD

195.4 Malig neo arm See Tables B-4

and B-8

See Table A-5 See Table B-6 See Table B-7 See Table B-5

195.5 Malig neo leg RSD See Table B-2 RSD (0.52) RSD (0.70) 10% ENSD

195.8 Malig neo site nec Remainder Remainder Remainder Remainder Remainder

196 Malig neo lymph nodes See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

196.0 Malig neo lymph-head/neck Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.1 Malig neo lymph-intrathor Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.2 Malig neo lymph-intra-abd Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.3 Malig neo lymph-axilla/arm Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.5 Malig neo lymph-inguin/leg Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.6 Malig neo lymph-intrapelv Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.8 Malig neo lymph-mult Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

196.9 Malig neo lymph nos Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197 Sec malig neo gi/resp See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

197.0 Sec malig neo lung Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.1 Sec malig neo mediastinum Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.2 Sec malig neo pleura Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.3 Sec malig neo resp nec Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.4 Sec malig neo sm bowel Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.5 Sec malig neo lg bowel Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.6 Sec malig neo peritoneum Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.7 Sec malig neo liver Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

197.8 Sec malig neo gi nec Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198 Sec malig neo other sites See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

198.0 Sec malig neo kidney Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.1 Sec malig neo urin nec Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.2 Sec malig neo skin Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.3 Sec malig neo brain/spine Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.4 Sec malig neo nerve nec Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.5 Sec malig neo bone Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.6 Sec malig neo ovary Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.7 Sec malig neo adrenal Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.8 Other secondary malig neo See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 61 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

198.81 Sec malig neo breast Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.82 Sec malig neo genital Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

198.89 Sec malig neo nec Likely siteb Likely siteb Likely siteb Likely siteb Likely siteb

199c Malig neoplasm nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

199.0c Malig neo disseminated Remainder Remainder Remainder Remainder Remainder

199.1c Malig neo nos Remainder Remainder Remainder Remainder Remainder

200 Lymphosarc/reticulosarc See Table A-2 Lung Lung Thyroid Lung

200.0 Reticulosarcoma See Table A-2 Lung Lung Thyroid Lung

200.00 Retclsrc unspec ext org See Table A-2 Lung Lung Thyroid Lung

200.01 Reticulosarcoma head See Table A-2 Lung Lung Thyroid Lung

200.02 Reticulosarcoma thorax See Table A-2 Lung Lung Lung Breast

200.03 Reticulosarcoma abdom Stomach Stomach Stomach Stomach Stomach

200.04 Reticulosarcoma axilla See Table A-2 Lung Lung Lung Breast

200.05 Reticulosarcoma inguin See Table A-2 See Table A-3 See Table A-4 Bladder Uterus

200.06 Reticulosarcoma pelvic See Table A-2 See Table A-3 See Table A-4 Bladder Uterus

200.07 Reticulosarcoma spleen Stomach Stomach Stomach Stomach Stomach

200.08 Reticulosarcoma mult See Table A-2 Lung Lung Thyroid Lung

200.1 Lymphosarcoma See Table A-2 Lung Lung Thyroid Lung

200.10 Lymphsrc unspec ext org See Table A-2 Lung Lung Thyroid Lung

200.11 Lymphosarcoma head See Table A-2 Lung Lung Thyroid Lung

200.12 Lymphosarcoma thorax See Table A-2 Lung Lung Thyroid Lung

200.13 Lymphosarcoma abdom Stomach Stomach Stomach Stomach Stomach

200.14 Lymphosarcoma axilla See Table A-2 Lung See Table A-4 Lung Breast

200.15 Lymphosarcoma inguin Bladder Bladder Bladder Bladder Bladder

200.16 Lymphosarcoma pelvic Bladder Bladder Bladder Bladder Bladder

200.17 Lymphosarcoma spleen Stomach Stomach Stomach Stomach Stomach

200.18 Lymphosarcoma mult See Table A-2 Lung Lung Thyroid Lung

200.2 Burkitt’s tumor/lymphoma See Table A-2 Lung See Table A-4 Lung Breast

200.20 Burkitt’s tumor unspec ext org See Table A-2 Lung See Table A-4 Lung Breast

200.21 Burkitt’s tumor head See Table A-2 Lung See Table A-4 Lung Breast

200.22 Burkitt’s tumor thorax See Table A-2 Lung See Table A-4 Lung Breast

200.23 Burkitt’s tumor abdom See Table A-2 Lung See Table A-4 Lung Breast

200.24 Burkitt’s tumor axilla See Table A-2 Lung See Table A-4 Lung Breast

200.25 Burkitt’s tumor inguin See Table A-2 Lung See Table A-4 Lung Breast

200.26 Burkitt’s tumor pelvic See Table A-2 Lung See Table A-4 Lung Breast

200.27 Burkitt’s tumor spleen See Table A-2 Lung See Table A-4 Lung Breast
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 62 of 114

ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

200.28 Burkitt’s tumor mult See Table A-2 Lung See Table A-4 Lung Breast

200.30 Marg zone lymphomas unspec Lung Lung Lung Lung Lung

200.31 Marg zone lymphomas head See Tables B-4 

and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

200.32 Marg zone lymphomas thorax Lung Lung Lung Lung Lung

200.33 Marg zone lymphomas abdom Stomach Stomach Stomach Stomach Stomach

200.34 Marg zone lymphomas axilla Lung Lung Lung Lung Lung

200.35 Marg zone lymphomas inguin Bladder Bladder Bladder Bladder Bladder

200.36 Marg zone lymphomas pelvic Bladder Bladder Bladder Bladder Bladder

200.37 Marg zone lymphomas spleen Stomach Stomach Stomach Stomach Stomach

200.38 Marg zone lymphomas mult Lung Lung Lung Lung Lung

200.40 Mantle cell lymphomas unspec Lung Lung Lung Lung Lung

200.41 Mantle cell lymphomas head See Tables B-4 

and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

200.42 Mantle cell lymphomas thorax Lung Lung Lung Lung Lung

200.43 Mantle cell lymphomas abdom Stomach Stomach Stomach Stomach Stomach

200.44 Mantle cell lymphomas axilla Lung Lung Lung Lung Lung

200.45 Mantle cell lymphomas inguin Bladder Bladder Bladder Bladder Bladder

200.46 Mantle cell lymphomas pelvic Bladder Bladder Bladder Bladder Bladder

200.47 Mantle cell lymphomas spleen Stomach Stomach Stomach Stomach Stomach

200.48 Mantle cell lymphomas mult Lung Lung Lung Lung Lung

200.50 Primary cns lymphomas unspec Lung Lung Lung Lung Lung

200.51 Primary cns lymphomas head See Tables

B41and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

200.52 Primary cns lymphomas thorax Lung Lung Lung Lung Lung

200.53 Primary cns lymphomas abdom Stomach Stomach Stomach Stomach Stomach

200.54 Primary cns lymphomas axilla Lung Lung Lung Lung Lung

200.55 Primary cns lymphomas inguin Bladder Bladder Bladder Bladder Bladder

200.56 Primary cns lymphomas pelvic Bladder Bladder Bladder Bladder Bladder

200.57 Primary cns lymphomas spleen Stomach Stomach Stomach Stomach Stomach

200.58 Primary cns lymphomas mult Lung Lung Lung Lung Lung

200.60 Anaplas lg cell lymphomas unspec Lung Lung Lung Lung Lung

200.61 Anaplas lg cell lymphomas head See Tables B-4 

and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

200.62 Anaplas lg cell lymphomas thorax Lung Lung Lung Lung Lung

200.63 Anaplas lg cell lymphomas abdom Stomach Stomach Stomach Stomach Stomach
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

200.64 Anaplas lg cell lymphomas axilla Lung Lung Lung Lung Lung

200.65 Anaplas lg cell lymphomas inguin Bladder Bladder Bladder Bladder Bladder

200.66 Anaplas lg cell lymphomas pelvic Bladder Bladder Bladder Bladder Bladder

200.67 Anaplas lg cell lymphomas spleen Stomach Stomach Stomach Stomach Stomach

200.68 Anaplas lg cell lymphomas mult Lung Lung Lung Lung Lung

200.70 Lg cell lymphomas unspec Lung Lung Lung Lung Lung

200.71 Lg cell lymphomas head See Tables B-4 

and B-8

Eye/brain See Table B-6 See Table B-7 Eye/brain

200.72 Lg cell lymphomas thorax Lung Lung Lung Lung Lung

200.73 Lg cell lymphomas abdom Stomach Stomach Stomach Stomach Stomach

200.74 Lg cell lymphomas axilla Lung Lung Lung Lung Lung

200.75 Lg cell lymphomas inguin Bladder Bladder Bladder Bladder Bladder

200.76 Lg cell lymphomas pelvic Bladder Bladder Bladder Bladder Bladder

200.77 Lg cell lymphomas spleen Stomach Stomach Stomach Stomach Stomach

200.78 Lg cell lymphomas mult Lung Lung Lung Lung Lung

200.8 Mixed lymphosarcoma See Table A-2 Lung Lung Thyroid Lung

200.80 Other varn unspec ext org See Table A-2 Lung Lung Thyroid Lung

200.81 Mixed lymphosarc head See Table A-2 Lung Lung Thyroid Lung

200.82 Mixed lymphosarc thorax See Table A-2 Lung Breast Lung Breast

200.83 Mixed lymphosarc abdom Stomach Stomach Stomach Stomach Stomach

200.84 Mixed lymphosarc axilla See Table A-2 Lung Breast Lung Breast

200.85 Mixed lymphosarc inguin Bladder Bladder Bladder Bladder Bladder

200.86 Mixed lymphosarc pelvic Bladder Bladder Bladder Bladder Bladder

200.87 Mixed lymphosarc spleen Stomach Stomach Stomach Stomach Stomach

200.88 Mixed lymphosarc mult See Table A-2 Lung Breast Lung Breast

201 Hodgkin’s disease See Table A-2 Lung Breast Lung Breast

201.0 Hodgkin’s paragranuloma See Table A-2 Lung Breast Lung Breast

201.00 Hodgkins paragranuloma unspec ext org See Table A-2 Lung Breast Lung Breast

201.01 Hodgkins paragran head See Table A-2 Lung Breast Lung Breast

201.02 Hodgkins paragran thorax Lung Lung Lung Lung Lung

201.03 Hodgkins paragran abdom Stomach Stomach Stomach Stomach Stomach

201.04 Hodgkins paragran axilla See Table A-2 Lung Breast Lung Breast

201.05 Hodgkins paragran inguin Bladder Bladder Bladder Bladder Bladder

201.06 Hodgkins paragran pelvic Bladder Bladder Bladder Bladder Bladder

201.07 Hodgkins paragran spleen Stomach Stomach Stomach Stomach Stomach

201.08 Hodgkins paragran mult See Table A-2 Lung Breast Lung Breast
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

201.1 Hodgkin’s granuloma See Table A-2 Lung Breast Lung Breast

201.10 Hodgkins granulom unspec ext org See Table A-2 Lung Breast Lung Breast

201.11 Hodgkins granulom head See Table A-2 Lung Breast Lung Breast

201.12 Hodgkins granulom thorax See Table A-2 Lung Lung Lung Lung

201.13 Hodgkins granulom abdom Stomach Stomach Stomach Stomach Stomach

201.14 Hodgkins granulom axilla Lung Lung Lung Lung Lung

201.15 Hodgkins granulom inguin Bladder Bladder Bladder Bladder Bladder

201.16 Hodgkins granulom pelvic Bladder Bladder Bladder Bladder Bladder

201.17 Hodgkins granulom spleen Stomach Stomach Stomach Stomach Stomach

201.18 Hodgkins granulom mult See Table A-2 Lung Lung Thyroid Lung

201.2 Hodgkin’s sarcoma See Table A-2 Lung Lung Thyroid Lung

201.20 Hodgkins src unspec ext org See Table A-2 Lung Lung Thyroid Lung

201.21 Hodgkins sarcoma head See Table A-2 Lung Lung Thyroid Lung

201.22 Hodgkins sarcoma thorax See Table A-2 Lung Breast Lung Breast

201.23 Hodgkins sarcoma abdom Stomach Stomach Stomach Stomach Stomach

201.24 Hodgkins sarcoma axilla See Table A-2 Lung Breast Lung Breast

201.25 Hodgkins sarcoma inguin Bladder Bladder Bladder Bladder Bladder

201.26 Hodgkins sarcoma pelvic Bladder Bladder Bladder Bladder Bladder

201.27 Hodgkins sarcoma spleen Stomach Stomach Stomach Stomach Stomach

201.28 Hodgkins sarcoma mult See Table A-2 Lung Lung Thyroid Lung

201.4 Hodgkins lymph-histiocyt See Table A-2 Lung Lung Thyroid Lung

201.40 Lym-hst unspec ext orgn See Table A-2 Lung Lung Thyroid Lung

201.41 Hodgkins lymph-histio head See Table A-2 Lung Lung Thyroid Lung

201.42 Hodgkins lymph-histio thorax See Table A-2 Lung Breast Lung Breast

201.43 Hodgkins lymph-histio abdom Stomach Stomach Stomach Stomach Stomach

201.44 Hodgkins lymph-histio axilla See Table A-2 Lung Breast Lung Breast

201.45 Hodgkins lymph-histio inguin Bladder Bladder Bladder Bladder Bladder

201.46 Hodgkins lymph-histio pelvic Bladder Bladder Bladder Bladder Bladder

201.47 Hodgkins lymph-histio spleen Stomach Stomach Stomach Stomach Stomach

201.48 Hodgkins lymph-histio mult See Table A-2 Lung Lung Thyroid Lung

201.5 Hodgkins nodular scleros See Table A-2 Lung Lung Thyroid Lung

201.50 Nodular scleros unspec ext org See Table A-2 Lung Lung Thyroid Lung

201.51 Hodgkins nodul sclero head See Table A-2 Lung Lung Thyroid Lung

201.52 Hodgkins nodul sclero thorax See Table A-2 Lung Breast Lung Breast

201.53 Hodgkins nodul sclero abdom Stomach Stomach Stomach Stomach Stomach

201.54 Hodgkins nodul sclero axilla See Table A-2 Lung Breast Lung Breast
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

201.55 Hodgkins nodul sclero inguin Bladder Bladder Bladder Bladder Bladder

201.56 Hodgkins nodul sclero pelvic Bladder Bladder Bladder Bladder Bladder

201.57 Hodgkins nodul sclero spleen Stomach Stomach Stomach Stomach Stomach

201.58 Hodgkins nodul sclero mult See Table A-2 Lung Lung Thyroid Lung

201.6 Hodgkins mix cellularity See Table A-2 Lung Lung Thyroid Lung

201.60 Mxd celr unspec ext org See Table A-2 Lung Lung Thyroid Lung

201.61 Hodgkins mix cell head See Table A-2 Lung Lung Thyroid Lung

201.62 Hodgkins mix cell thorax See Table A-2 Lung Breast Lung Breast

201.63 Hodgkins mix cell abdom Stomach Stomach Stomach Stomach Stomach

201.64 Hodgkins mix cell axilla See Table A-2 Lung Breast Lung Breast

201.65 Hodgkins mix cell inguin Bladder Bladder Bladder Bladder Bladder

201.66 Hodgkins mix cell pelvic Bladder Bladder Bladder Bladder Bladder

201.67 Hodgkins mix cell spleen Stomach Stomach Stomach Stomach Stomach

201.68 Hodgkins mix cell mult See Table A-2 Lung Lung Thyroid Lung

201.7 Hodg lymphocytic deplet See Table A-2 Lung Lung Thyroid Lung

201.70 Lym dplt unspec ext org See Table A-2 Lung Lung Thyroid Lung

201.71 Hodgkins lymph deplet head See Table A-2 Lung Lung Thyroid Lung

201.72 Hodgkins lymph deplet thorax See Table A-2 Lung Breast Lung Breast

201.73 Hodgkins lymph deplet abdom Stomach Stomach Stomach Stomach Stomach

201.74 Hodgkins lymph deplet axilla See Table A-2 Lung Breast Lung Breast

201.75 Hodgkins lymph deplet inguin Bladder Bladder Bladder Bladder Bladder

201.76 Hodgkins lymph deplet pelvic Bladder Bladder Bladder Bladder Bladder

201.77 Hodgkins lymph deplet spleen Stomach Stomach Stomach Stomach Stomach

201.78 Hodgkins lymph deplet mult See Table A-2 Lung Lung Thyroid Lung

201.9 Hodgkins disease nos See Table A-2 Lung Lung Thyroid Lung

201.90 Hdgk disease unspec ext org See Table A-2 Lung Lung Thyroid Lung

201.91 Hodgkins disease nos head See Table A-2 Lung Lung Thyroid Lung

201.92 Hodgkins disease nos thorax See Table A-2 Lung Breast Lung Breast

201.93 Hodgkins disease nos abdom Stomach Stomach Stomach Stomach Stomach

201.94 Hodgkins disease nos axilla See Table A-2 Lung Breast Lung Breast

201.95 Hodgkins disease nos inguin Bladder Bladder Bladder Bladder Bladder

201.96 Hodgkins disease nos pelvic Bladder Bladder Bladder Bladder Bladder

201.97 Hodgkins disease nos spleen Stomach Stomach Stomach Stomach Stomach

201.98 Hodgkins disease nos mult See Table A-2 Lung Lung Thyroid Lung

202 Other malig neo lymph/histio Lung Lung Lung Lung Lung

202.0 Nodular lymphoma Lung Lung Lung Lung Lung
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

202.00 Ndlr lym unspec ext org Lung Lung Lung Lung Lung

202.01 Nodular lymphoma head Lung Lung Lung Lung Lung

202.02 Nodular lymphoma thorax Lung Lung Lung Lung Lung

202.03 Nodular lymphoma abdom Lung Lung Lung Lung Lung

202.04 Nodular lymphoma axilla Lung Lung Lung Lung Lung

202.05 Nodular lymphoma inguin Lung Lung Lung Lung Lung

202.06 Nodular lymphoma pelvic Lung Lung Lung Lung Lung

202.07 Nodular lymphoma spleen Lung Lung Lung Lung Lung

202.08 Nodular lymphoma mult Lung Lung Lung Lung Lung

202.1 Mycosis fungoides See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.10 Mycs fng unspec ext org See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.11 Mycosis fungoides head See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.12 Mycosis fungoides thorax See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.13 Mycosis fungoides abdom See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.14 Mycosis fungoides axilla See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.15 Mycosis fungoides inguin See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.16 Mycosis fungoides pelvic See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.17 Mycosis fungoides spleen See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.18 Mycosis fungoides mult See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.2 Sezary’s disease See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.20 Szry disease unspec ext org See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.21 Sezary’s disease head See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

202.22 Sezary’s disease thorax See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.23 Sezary’s disease abdom See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.24 Sezary’s disease axilla See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.25 Sezary’s disease inguin See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.26 Sezary’s disease pelvic See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.27 Sezary’s disease spleen See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.28 Sezary’s disease mult See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.3 Malig histiocytosis See Table A-2 Lung Lung Thyroid Lung

202.30 Mlg hist unspec ext org See Table A-2 Lung Lung Thyroid Lung

202.31 Malig histiocytosis head See Table A-2 Lung Lung Thyroid Lung

202.32 Malig histiocytosis thorax See Table A-2 Lung Breast Lung Breast

202.33 Malig histiocytosis abdom Stomach Stomach Stomach Stomach Stomach

202.34 Malig histiocytosis axilla See Table A-2 Lung Breast Lung Breast

202.35 Malig histiocytosis inguin Bladder Bladder Bladder Bladder Bladder

202.36 Malig histiocytosis pelvic Bladder Bladder Bladder Bladder Bladder

202.37 Malig histiocytosis spleen Stomach Stomach Stomach Stomach Stomach

202.38 Malig histiocytosis mult See Table A-2 Lung Lung Thyroid Lung

202.4 Leukem reticuloendothel Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.40 Lk rtctl unspec ext org Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.41 Hairy-cell leukem head Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.42 Hairy-cell leukem thorax Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.43 Hairy-cell leukem abdom Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.44 Hairy-cell leukem axilla Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.45 Hairy-cell leukem inguin Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.46 Hairy-cell leukem pelvic Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.47 Hairy-cell leukem spleen Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.48 Hairy-cell leukem mult Bone Marrow Bone Marrow Bone Marrow Bone Marrow Bone Marrow

202.5 Letterer-siwe disease See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

202.50 Ltr-siwe unspec ext org See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.51 Letterer-siwe disease head See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.52 Letterer-siwe disease thorax See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.53 Letterer-siwe disease abdom See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.54 Letterer-siwe disease axilla See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.55 Letterer-siwe disease inguin See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.56 Letterer-siwe disease pelvic See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.57 Letterer-siwe disease spleen See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.58 Letterer-siwe disease mult See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.6 Malig mast cell tumors See Table A-2 Lung Lung Thyroid Lung

202.60 Malig mast unspec ext org See Table A-2 Lung Lung Thyroid Lung

202.61 Malig mastocytosis head See Table A-2 Lung Lung Thyroid Lung

202.62 Malig mastocytosis thorax See Table A-2 Lung Breast Lung Breast

202.63 Malig mastocytosis abdom Stomach Stomach Stomach Stomach Stomach

202.64 Malig mastocytosis axilla See Table A-2 Lung Breast Lung Breast

202.65 Malig mastocytosis inguin Bladder Bladder Bladder Bladder Bladder

202.66 Malig mastocytosis pelvic Bladder Bladder Bladder Bladder Bladder

202.67 Malig mastocytosis spleen Stomach Stomach Stomach Stomach Stomach

202.68 Malig mastocytosis mult See Table A-2 Lung Lung Thyroid Lung

202.7 Peripheral t cell (cutaneous) lymphoma 

unspec ext org

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.70 Peripheral t cell (cutaneous) lymphoma 

unspec ext org

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.71 Peripheral t cell (cutaneous) lymphoma head See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.72 Peripheral t cell (cutaneous) lymphoma 

thorax

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

202.73 Peripheral t cell (cutaneous) lymphoma 

abdom

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.74 Peripheral t cell (cutaneous) lymphoma axilla See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.75 Peripheral t cell (cutaneous) lymphoma 

inguin

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.76 Peripheral t cell (cutaneous) lymphoma 

pelvic

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.77 Peripheral t cell (cutaneous) lymphoma 

spleen

See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.78 Peripheral t cell (cutaneous) lymphoma See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

202.8 Lymphomas nec Lung Lung Lung Lung Lung

202.80 Other lymp unspec ext org Lung Lung Lung Lung Lung

202.81 Lymphomas nec head Lung Lung Lung Lung Lung

202.82 Lymphomas nec thorax Lung Lung Lung Lung Lung

202.83 Lymphomas nec abdom Lung Lung Lung Lung Lung

202.84 Lymphomas nec axilla Lung Lung Lung Lung Lung

202.85 Lymphomas nec inguin Lung Lung Lung Lung Lung

202.86 Lymphomas nec pelvic Lung Lung Lung Lung Lung

202.87 Lymphomas nec spleen Lung Lung Lung Lung Lung

202.88 Lymphomas nec mult Lung Lung Lung Lung Lung

202.9 Malig neo lym/hist tis nec Lung Lung Lung Lung Lung

202.90 Unspec lym unspec ext org Lung Lung Lung Lung Lung

202.91 Lymphoid malig nec head Lung Lung Lung Lung Lung

202.92 Lymphoid malig nec thorax Lung Lung Lung Lung Lung

202.93 Lymphoid malig nec abdom Lung Lung Lung Lung Lung

202.94 Lymphoid malig nec axilla Lung Lung Lung Lung Lung

202.95 Lymphoid malig nec inguin Lung Lung Lung Lung Lung

202.96 Lymphoid malig nec pelvic Lung Lung Lung Lung Lung

202.97 Lymphoid malig nec spleen Lung Lung Lung Lung Lung

202.98 Lymphoid malig nec mult Lung Lung Lung Lung Lung

203 Multiple myeloma et al Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.0 Multiple myeloma Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.00 Mult myelm w/o remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.01 Mult myelm w/remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

203.02 Mult myelm in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.1 Plasma cell leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.10 Plsm cell leuk w/o remisson Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.11 Plsm cell leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.12 Plsm cell leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.8 Immunoproliferat neoplasm nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.80 Other imnprfl npl w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.81 Other imnprfl npl w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

203.82 Other imnprfl npl in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204 Lymphoid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.0 Acute lymphoid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.00 Act lym leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.01 Act lym leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.02 Act lym leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.1 Chronic lymphoid leukemia See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082

204.10 Chronic lym leuk w/o remiss See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082

204.11 Chronic lym leuk w/remiss See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082

204.12 Chronic lym leuk in relapse See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082 See OTIB-0082

204.2 Subacute lymphoid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.20 Sbac lym leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.21 Sbac lym leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.22 Sbac lym leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.8 Lymphoid leukemia nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.80 Other lym leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.81 Other lym leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.82 Other lym leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.9 Lymphoid leukemia nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.90 Uns lym leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.91 Uns lym leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

204.92 Uns lym leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205 Myeloid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.0 Acute myeloid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.00 Act myl leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.01 Act myl leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.02 Act myl leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.1 Chronic myeloid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

205.10 Chronic myl leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.11 Chronic myl leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.12 Chronic myl leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.2 Subacut myeloid leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.20 Sbac myl leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.21 Sbac myl leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.22 Sbac myl leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.3 Myeloid sarcoma Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.30 Myl srcoma w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.31 Myl srcoma w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.32 Myl srcoma in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.8 Myeloid leukemia nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.80 Other myl leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.81 Other myl leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.82 Other myl leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.9 Myeloid leukemia nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.90 Uns myl leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.91 Uns myl leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

205.92 Uns myl leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206 Monocytic leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.0 Acute monocytic leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.00 Act mono leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.01 Act mono leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.02 Act mono leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.1 Chronic monocytic leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.10 Chronic mono leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.11 Chronic mono leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.12 Chronic mono leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.2 Subac monocytic leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.20 Sbacute mono leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.21 Sbacute mono leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.22 Sbacute mono leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.8 Monocytic leukemia nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.80 Other mono leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.81 Other mono leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.82 Other mono leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

206.9 Monocytic leukemia nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.90 Uns mono leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.91 Uns mono leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

206.92 Uns mono leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207 Other specified leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.0 Acute erythremia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.00 Act erth/erylk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.01 Act erth/erylk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.02 Act erth/erylk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.1 Chronic erythremia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.10 Chronic erythrm w/o remision Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.11 Chronic erythrm w/remision Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.12 Chronic erythrm in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.2 Megakaryocytic leukemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.20 Mgkrycyt leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.21 Mgkrycyt leuk w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.22 Mgkrycyt leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.8 Specified leukemia nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.80 Other spf leuk w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.81 Other spf leuk w/remsion Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

207.82 Other spf leuk in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208 Leukemia-unspecif cell Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.0 Act leuk uns cl w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.00 Act leuk uns cl w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.01 Act leuk uns cl w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.02 Act leuk uns cl in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.1 Chronic leukemia nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.10 Chronic leuk uns cl w/o remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.11 Chronic leuk uns cl w/remiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.12 Chronic leuk uns cl in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.2 Subacute leukemia nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.20 Subacute leukemia uns cl w/o remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.21 Subacute leukemia uns cl w/remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.22 Subacute leukemia uns cl in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.8 Leukemia-unspec cell nec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.80 Other leuk uns cl w/o remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

208.81 Other leuk uns cl w/remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.82 Other leuk uns cl in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.9 Leukemia-unspec cell nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.90 Other leuk nos w/o remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.91 Other leuk nos w/remission Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

208.92 Other leuk nos in relapse Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

209 Malig carc tumor si, unspec Stomach Stomach Stomach Stomach Stomach

209.01 Malig carc tumor duodenum Stomach Stomach Stomach Stomach Stomach

209.02 Malig carc tumor jejunum Stomach Stomach Stomach Stomach Stomach

209.03 Malig carc tumor ileum Colon Colon Colon Colon Colon

209.10 Malig carc tumor li, unspec Stomach Stomach Stomach Stomach Stomach

209.11 Malig carc tumor appendix Colon Colon Colon Colon Colon

209.12 Malig carc tumor cecum Colon Colon Colon Colon Colon

209.13 Malig carc tumor ascend colon Stomach Stomach Stomach Stomach Colon

209.14 Malig carc tumor trans colon Stomach Stomach Stomach Stomach Colon

209.15 Malig carc tumor decend colon Stomach Stomach Stomach Stomach Colon

209.16 Malig carc tumor sig colon Colon Colon Colon Colon Colon

209.17 Malig carc tumor rectum Colon Colon Colon Colon Colon

209.20 Malig carc tumor unknown site Remainder Remainder Remainder Remainder Colon

209.21 Malig carc tumor lung Lung Lung Lung Lung Lung

209.22 Malig carc tumor thymus Thymus Thymus Thymus Thymus Thymus

209.23 Malig carc tumor stomach Stomach Stomach Stomach Stomach Stomach

209.24 Malig carc tumor kidney Liver Liver Liver Liver Liver

209.25 Malig carc tumor foregut, unspec Remainder Remainder Remainder Remainder Remainder

209.26 Malig carc tumor midgut, unspec Remainder Remainder Remainder Remainder Remainder

209.27 Malig carc tumor hindgut, unspec Remainder Remainder Remainder Remainder Remainder

209.29 Malig carc tumor other sites Remainder Remainder Remainder Remainder Remainder

209.30 Malig poor diff neuroend carc, any site Remainder Remainder Remainder Remainder Remainder

209.31 Merkle cell carc face See Tables B-4 

and B-8

Eye/brain See Table A-4 See Table A-5 See Table B-5

209.32 Merkle cell carc scalp/neck See Tables B-4 

and B-8

Eye/brain See Table A-4 See Table A-5 See Table B-5

209.33 Merkle cell carc upper limb See Tables B-4 

and B-8

See Tables B-5

and B-9

See Table A-4 See Table A-5 See Table B-5

209.34 Merkle cell carc lower limb RSD See Tables B-5

and B-9

RSD (0.52 m) RSD (0.70 m) See Table B-5
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

209.35 Merkle cell carc trunk ENSD See Tables B5and B-9See Table A-4 See Table A-5 See Table B-5

209.36 Merkle cell carc other sites ENSD ENSD See Table A-4 See Table A-5 See Table B-5

230 Ca in situ digestive org See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

230.0 Ca in situ oral cav/phar Thyroid Thyroid Thyroid Thyroid Thyroid

230.1 Ca in situ esophagus Esophagus Esophagus Esophagus Esophagus Esophagus

230.2 Ca in situ stomach Stomach Stomach Stomach Stomach Stomach

230.3 Ca in situ colon Colon Colon Colon Colon Colon

230.4 Ca in situ rectum Colon Colon Colon Colon Colon

230.5 Ca in situ anal canal Colon Colon Colon Colon Colon

230.6 Ca in situ anus nos Colon Colon Colon Colon Colon

230.7 Ca in situ bowel nec/nos Colon Colon Colon Colon Colon

230.8 Ca in situ liver/biliary Liver Liver Liver Liver Liver

230.9 Ca in situ gi nec/nos Remainder Remainder Remainder Remainder Remainder

231 Ca in situ respiratory See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

231.0 Ca in situ larynx Thyroid Thyroid Thyroid Thyroid Esophagus

231.1 Ca in situ trachea Thyroid Thyroid Thyroid Thyroid Thyroid

231.2 Ca in situ bronchus/lung Lung Lung Lung Lung Lung

231.8 Ca in situ resp sys nec Lung Lung Lung Lung Lung

231.9 Ca in situ resp sys nos Lung Lung Lung Lung Lung

232 Carcinoma in situ skin See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

232.0 Ca in situ skin lip See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.1 Ca in situ eyelid See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.2 Ca in situ skin ear See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.3 Ca in situ skin face nec See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.4 Ca in situ scalp See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.5 Ca in situ skin trunk See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.6 Ca in situ skin arm See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5
ATTACHMENT A 

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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

232.7 Ca in situ skin leg See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.8 Ca in situ skin nec See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

232.9 Ca in situ skin nos See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

233 Ca in situ breast/gu See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

233.0 Ca in situ breast Breast Breast Breast Breast Breast

233.1 Ca in situ cervix uteri Uterus Uterus Uterus Uterus Uterus

233.2 Ca in situ uterus nec Uterus Uterus Uterus Uterus Uterus

233.3 Ca in situ fem gen nec Uterus Uterus Uterus Uterus Uterus

233.30 Ca in situ fem gen unspec Uterus Uterus Uterus Uterus Uterus

233.31 Ca in situ vagina Uterus Uterus Uterus Uterus Uterus

233.32 Ca in situ vulva Uterus Uterus Uterus Uterus Uterus

233.39 Ca in situ other fem gen Uterus Uterus Uterus Uterus Uterus

233.4 Ca in situ prostate Bladder Bladder Bladder Bladder Bladder

233.5 Ca in situ penis Testes Testes Testes Testes Testes

233.6 Ca in situ male gen nec Testes Testes Testes Testes Testes

233.7 Ca in situ bladder Bladder Bladder Bladder Bladder Bladder

233.9 Ca in situ urinary nec Bladder Bladder Bladder Bladder Bladder

234 Ca in situ nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

234.0 Ca in situ eye Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

234.8 Ca in situ nec Remainder Remainder Remainder Remainder Remainder

234.9 Ca in situ nos Remainder Remainder Remainder Remainder Remainder

235 Uncert behav neoplasm gi/resp See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

235.0 Uncert behav neoplasm salivary Thyroid Thyroid Thyroid Thyroid Thyroid

235.1 Uncert behav neoplasm oral/phar Thyroid Thyroid Thyroid Thyroid Thyroid

235.2 Uncert behav neoplasm intestine (stomach) Stomach Stomach Stomach Stomach Stomach

235.2 Uncert behav neoplasm intestine (colon) Colon Colon Colon Colon Colon

235.2 Uncert behav neoplasm intestine (rectum) Colon Colon Colon Colon Colon

235.3 Uncert behav neoplasm liver Liver Liver Liver Liver Liver

235.4 Uncert behav neoplasm peritoneum Stomach Stomach Stomach Stomach Stomach

235.5 Uncert behav neoplasm gi nec Stomach Stomach Stomach Stomach Stomach

235.6 Uncert behav neoplasm larynx Thyroid Thyroid Thyroid Thyroid Thyroid

235.7 Uncert behav neoplasm lung Lung Lung Lung Lung Lung

235.8 Uncert behav neoplasm pleura Lung Lung Lung Lung Lung
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

235.9 Uncert behav neoplasm resp nec Lung Lung Lung Lung Lung

236 Uncert behav neoplasm gu See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

236.0 Uncert behav neoplasm uterus Uterus Uterus Uterus Uterus Uterus

236.1 Uncert behav neoplasm placenta Uterus Uterus Uterus Uterus Uterus

236.2 Uncert behav neoplasm ovary Ovaries Ovaries Ovaries Ovaries Ovaries

236.3 Uncert behav neoplasm female nec Uterus Uterus Uterus Uterus Uterus

236.4 Uncert behav neoplasm testis Testes Testes Testes Testes Testes

236.5 Uncert behav neoplasm prostate Bladder Bladder Bladder Bladder Bladder

236.6 Uncert behav neoplasm male nec Testes Testes Testes Testes Testes

236.7 Uncert behav neoplasm bladder Bladder Bladder Bladder Bladder Bladder

236.9 Uncert behav neoplasm other urinar Liver Liver Liver Liver Liver

236.90 Uncert behav neoplasm urinar nos Liver Liver Liver Liver Liver

236.91 Uncert behav neoplasm kidney Liver Liver Liver Liver Liver

236.99 Uncert behav neoplasm urinar nec Liver Liver Liver Liver Liver

237 Uncer neoplasm endocrine/nerv See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

237.0 Uncert behav neoplasm pituitary Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

237.1 Uncert behav neoplasm pineal Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

237.2 Uncert behav neoplasm adrenal Remainder Remainder Remainder Remainder Remainder

237.3 Uncert behav neoplasm paragang Remainder Remainder Remainder Remainder Remainder

237.4 Uncer neoplasm endocrine nec Remainder Remainder Remainder Remainder Remainder

237.5 Uncert beh neoplasm brain/spinal Remainder Remainder Thyroid Thyroid Thyroid

237.6 Uncert behav neoplasm meninges Remainder Remainder Remainder Remainder Remainder

237.7 Neurofibromatosis Remainder Remainder Remainder Remainder Remainder

237.70 Neurofibromatosis nos Remainder Remainder Remainder Remainder Remainder

237.71 Neurofibromatosis type i Remainder Remainder Remainder Remainder Remainder

237.72 Neurofibromatosis typ ii Remainder Remainder Remainder Remainder Remainder

237.9 Uncert beh neoplasm nerv sys nec Remainder Remainder Remainder Remainder Remainder

238 Uncert behav neoplasm nec/nos See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

238.0 Uncert behav neoplasm bone Bone Surface Bone Surface Bone Surface Bone Surface Bone Surface

238.1 Uncert behav neoplasm soft tissu Remainder Remainder Remainder Remainder Remainder

238.2 Uncert behav neoplasm skin See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

238.3 Uncert behav neoplasm breast Breast Breast Breast Breast Breast

238.4 Polycythemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.5 Mastocytoma nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.6 Plasmacytoma nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

238.7 Lymphoproliferat disease nos Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.71 Ess thrombocythemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.72 Lowgrade myelodyspl synd Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.73 Highgrade myelodyspl synd Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.74 Hmyelodyspl synd w/5q del Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.75 Myelodyspl synd, unspec Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.76 Myelofibrosis w/myeloid meta Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.79 Other lymphatic/hematop tiss Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

238.8 Uncert behavior neoplasm nec Remainder Remainder Remainder Remainder Remainder

238.9 Uncert behavior neoplasm nos Remainder Remainder Remainder Remainder Remainder

239 Unspecified neoplasm See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

239.0 Digestive neoplasm nos Stomach Stomach Stomach Stomach Stomach

239.1 Respiratory neoplasm nos Lung Lung Lung Lung Lung

239.2 Bone/skin neoplasm nos (bone) Bone surface Bone surface Bone surface Bone surface Bone surface

239.2 Bone/skin neoplasm nos (skin) See Tables B-4 

and B-8

See Tables B-5 

and B-9

See Table B-6 See Table B-7 See Table B-5

239.3 Breast neoplasm nos Breast Breast Breast Breast Breast

239.4 Bladder neoplasm nos Bladder Bladder Bladder Bladder Bladder

239.5 Other gu neoplasm nos (female) Bladder Bladder Bladder Bladder Bladder

239.5 Other gu neoplasm nos (male) Bladder Bladder Bladder Bladder Testes

239.6 Brain neoplasm nos Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

239.7 Brain/nerv neoplasm nos Remainder Remainder Remainder Remainder Remainder

239.7 Endocrine nos Remainder Remainder Remainder Remainder Remainder

239.8 Neoplasm nos, site nec Remainder Remainder Remainder Remainder Remainder

239.81 Neoplasm nos, retina/choroid Eye/brain Eye/brain Eye/brain Eye/brain Eye/brain

239.89 Neoplasm nos, other spec sites Remainder Remainder Remainder Remainder Remainder

239.9 Neoplasm nos Remainder Remainder Remainder Remainder Remainder

258.02 Multiple endocrine neo [men] type IIA Remainder Remainder Remainder Remainder Remainder

273 Disorders of plasma protein metabolism See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

273.3 Waldenstrom’s macroglobulinemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289 Other specified blood disorder See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below See Subcodes Below

289.7 Essential thrombocytosis Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289.8 Other specified diseases of blood and bloodforming organsBone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289.81 Primary hypercoag state Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289.82 Secondary hypercoag state Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow
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ICD-9 

code Cancer code explanation PFG and chest Lumbar spine Thoracic spine Cervical spine Pelvis

289.83 Myelofibrosis Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289.89 Unspecified diseases of blood and bloodforming organsBone marrow Bone marrow Bone marrow Bone marrow Bone marrow

289.9 Essential thrombocythemia Bone marrow Bone marrow Bone marrow Bone marrow Bone marrow

a. For ICD-9 codes 150.2, 150.5, and 150.8, stomach should be used if diagnosis is adenocarcinoma distal esophagus. See discussion in Section 4.8 of ORAUT-OTIB0005 for additional information. 

b. 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.

c. For ICD-9 codes 199, 199.0, and 199.1, see discussion in Section 3.2 of ORAUT-OTIB-0005.

Table A-2. Selection of organs for chest X-ray dose reconstruction based on ICD-9 code when different organ selection required based on 

view.a 

ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

200 Lymphosarc/

reticulosarc

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.0 Reticulosarcoma Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.00 Retclsrc unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.01 Reticulosarcoma 

head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.02 Reticulosarcoma 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.04 Reticulosarcoma 

axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.05 Reticulosarcoma 

inguin

Bladder Bladder Uterus Bladder Bladder Uterus Bladder Bladder Uterus

200.06 Reticulosarcoma 

pelvic

Bladder Bladder Uterus Bladder Bladder Uterus Bladder Bladder Uterus

200.08 Reticulosarcoma 

mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.1 Lymphosarcoma Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.10 Lymphsrc unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.11 Lymphosarcoma 

head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung
ATTACHMENT A 

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ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

200.12 Lymphosarcoma 

thorax

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.14 Lymphosarcoma 

axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.18 Lymphosarcoma 

mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.2 Burkitt’s 

tumor/lymphoma

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.20 Burkitt’s tumor 

unspec ext org

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.21 Burkitt’s tumor 

head

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.22 Burkitt’s tumor 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.23 Burkitt’s tumor 

abdom

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.24 Burkitt’s tumor 

axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.25 Burkitt’s tumor 

inguin

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.26 Burkitt’s tumor 

pelvic

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.27 Burkitt’s tumor 

spleen

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.28 Burkitt’s tumor 

mult

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.8 Mixed 

lymphosarcoma

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.80 Other varn 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

200.81 Mixed 

lymphosarc head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung
ATTACHMENT A 

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0 of 114

ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

200.82 Mixed 

lymphosarc 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.84 Mixed 

lymphosarc axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

200.88 Mixed 

lymphosarc mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201 Hodgkin’s 

disease

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.0 Hodgkin’s 

paragranuloma

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.00 Hodgkins 

paragranuloma 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.01 Hodgkins 

paragran head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.04 Hodgkins 

paragran axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.08 Hodgkins 

paragran mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.1 Hodgkin’s 

granuloma

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.10 Hodgkins 

granulom unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.11 Hodgkins 

granulom head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.12 Hodgkins 

granulom thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.18 Hodgkins 

granulom mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.2 Hodgkin’s 

sarcoma

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung
ATTACHMENT A 

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ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

201.20 Hodgkins src 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.21 Hodgkins 

sarcoma head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.22 Hodgkins 

sarcoma thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.24 Hodgkins 

sarcoma axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.28 Hodgkins 

sarcoma mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.4 Hodgkins lymphhistiocytLung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.40 Lym-hst unspec 

ext orgn

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.41 Hodgkins lymphhistio headLung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.42 Hodgkins lymphhistio thoraxBreast Lung Lung Breast Breast Breast Breast Breast Lung

201.44 Hodgkins lymphhistio axillaBreast Lung Lung Breast Breast Breast Breast Breast Lung

201.48 Hodgkins lymphhistio multLung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.5 Hodgkins nodular 

scleros

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.50 Nodular scleros 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.51 Hodgkins nodul 

sclero head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.52 Hodgkins nodul 

sclero thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.54 Hodgkins nodul 

sclero axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.58 Hodgkins nodul 

sclero mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 82 of 114

ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

201.6 Hodgkins mix 

cellularity

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.60 Mxd celr unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.61 Hodgkins mix cell 

head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.62 Hodgkins mix cell 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.64 Hodgkins mix cell 

axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.68 Hodgkins mix cell 

mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.7 Hodg lymphocytic 

deplet

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.70 Lym dplt unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.71 Hodgkins lymph 

deplet head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.72 Hodgkins lymph 

deplet thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.74 Hodgkins lymph 

deplet axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.78 Hodgkins lymph 

deplet mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.9 Hodgkins disease 

nos

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.90 Hdgk disease 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.91 Hodgkins disease 

nos head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

201.92 Hodgkins disease 

nos thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

201.94 Hodgkins disease 

nos axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 83 of 114

ICD-9 

code

Cancer code 

explanation PFG

PA 

chest 

through

1970

PA 

chest after 

1970

LAT 

chest 

through 

1970

LAT chest 

after 1970

AP lordotic 

chest 

through 

1970

RAO 

chest 

through 

1970

LAO 

chest 

through 

1970

Chest 

fluoroscopy 

through 1970

201.98 Hodgkins disease 

nos mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.3 Malig 

histiocytosis

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.30 Mlg hist unspec 

ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.31 Malig 

histiocytosis head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.32 Malig 

histiocytosis 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

202.34 Malig 

histiocytosis axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

202.38 Malig 

histiocytosis mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.6 Malig mast cell 

tumors

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.60 Malig mast 

unspec ext org

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.61 Malig 

mastocytosis 

head

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

202.62 Malig 

mastocytosis 

thorax

Breast Lung Lung Breast Breast Breast Breast Breast Lung

202.64 Malig 

mastocytosis 

axilla

Breast Lung Lung Breast Breast Breast Breast Breast Lung

202.68 Malig 

mastocytosis mult

Lung Lung Lung Lung Lung Thyroid Lung Lung Lung

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)
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 84 of 114

Table A-3. Selection of organs for lumbar spine X-ray dose reconstruction based on ICD-9 code when different organ selection required 

based on view.

ICD-9 

code Cancer code explanation

AP 

lumbar spine 

through 1970

AP 

lumbar spine 

after 1970

LAT 

lumbar spine 

through 1970

LAT 

lumbar spine 

after 1970

170.4 Malig neo long bones arm ENSDa 10% ENSD 10% ENSD 10% ENSD

170.5 Malig neo bones wrist/hand ENSD 10% ENSD 10% ENSD 10% ENSD

171.2 Malig neo soft tissue arm ENSD 10% ENSD 10% ENSDb 10% ENSDb

195.4 Malig neo arm ENSDa 10% ENSD 10% ENSD 10% ENSD

200.05 Reticulosarcoma inguin Ovaries Uterus Ovaries Ovaries

200.06 Reticulosarcoma pelvic Ovaries Uterus Ovaries Ovaries

a. Upper arm would be 10% ENSD

b. Right side – assign 10% ENSD, Left side – assign 10% EXSD

Table A-4. Selection of organs for thoracic spine X-ray dose reconstruction based on ICD-9 code when different organ selection required 

based on view.

ICD-9 

code Cancer code explanation

AP 

thoracic spine

LAT 

thoracic spine

RPO 

thoracic spine

LPO 

thoracic spine

171.4 Malig neo soft tis thorax ENSD Lunga ENSD ENSD

171.5 Malig neo soft tis abdomen ENSD Lunga ENSD ENSD

171.7 Malig neo trunk nos ENSD Lunga ENSD ENSD

171.8 Malig neo soft tissue nec ENSD Lunga ENSD ENSD

171.9 Malig neo soft tissue nos ENSD Lunga ENSD ENSD

200.05 Reticulosarcoma inguin Uterus Ovaries Uterus Uterus

200.06 Reticulosarcoma pelvic Uterus Ovaries Uterus Uterus

200.2 Burkitt’s tumor/lymphoma Breast Lung Breast Breast

200.20 Burkitt’s tumor unspec ext org Breast Lung Breast Breast

200.21 Burkitt’s tumor head Breast Lung Breast Breast

200.22 Burkitt’s tumor thorax Breast Lung Breast Breast

200.23 Burkitt’s tumor abdom Breast Lung Breast Breast

200.24 Burkitt’s tumor axilla Breast Lung Breast Breast

200.25 Burkitt’s tumor inguin Breast Lung Breast Breast

200.26 Burkitt’s tumor pelvic Breast Lung Breast Breast

200.27 Burkitt’s tumor spleen Breast Lung Breast Breast

200.28 Burkitt’s tumor mult Breast Lung Breast Breast

209.31 Merkle cell carc face 10% ENSD Eye/brain 10% ENSDb 10% ENSDc

209.32 Merkle cell carc scalp/neck ENSD Eye/brain 10% ENSDb 10% ENSDc
ATTACHMENT A 

SELECTION OF ORGAN BASED ON ICD-9 CODE TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 85 of 114

ICD-9 

code Cancer code explanation

AP 

thoracic spine

LAT 

thoracic spine

RPO 

thoracic spine

LPO 

thoracic spine

209.33 Merkle cell carc upper limb ENSD ENSDd ENSD ENSD

209.35 Merkle cell carc trunk ENSD Lunga ENSD ENSD

209.36 Merkle cell carc other sites ENSD Lunga ENSD ENSD

a. The higher of the male or female lung dose value should be used for both genders

b. Right side of head = 10% EXSD; Left side of head = 10% ENSD

c. Right side of head = 10% ENSD; Left side of head = 10% EXSD

d. Right upper arm = ENSD; Left upper arm = EXSD; Elbow and below = 10% ENSD

Table A-5. Selection of organs for cervical spine X-ray dose reconstruction based on ICD-9 code when different organ selection required 

based on view.

ICD-9 

code Cancer code explanation

AP 

cervical spine

LAT 

cervical spine

RPO 

cervical spine 

LPO 

cervical spine 

171.4 Malig neo soft tis thorax ENSD 10% ENSD ENSD ENSD

171.7 Malig neo trunk nos ENSD 10% ENSD ENSD ENSD

171.8 Malig neo soft tissue nec ENSD 10% ENSD ENSD ENSD

171.9 Malig neo soft tissue nos ENSD 10% ENSD ENSD ENSD

209.31 Merkle cell carc face ENSD ENSDa ENSDb ENSDa

209.32 Merkle cell carc scalp/neck ENSDd ENSDa ENSDb ENSDa

209.33 Merkle cell carc upper limb 10% ENSD 10% ENSD 10% EXSDe 10% ENSDf

209.35 Merkle cell carc trunk ENSD 10% ENSD ENSDc ENSDc

209.36 Merkle cell carc other sites ENSD 10% ENSD ENSDc ENSDc

a. Right side of head = ENSD; Left side of head = EXSD.

b. Right side of head = EXSD; Left side of head = ENSD.

c. Dose assigned may be adjusted in accordance with Table B-4 if specific location can be determined.

d. Front of neck/scalp = ENSD; Back of neck/scalp = EXSD.

e. Right upper arm = 10% EXSD; Left upper arm = 10% ENSD; Elbow and below = RSD (0.40 m).

f. Right upper arm = 10% ENSD; Left upper arm = 10% EXSD; Elbow and below = RSD (0.40 m).
Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 86 of 114

 

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..........................................................................................................................87

B-2 DCFs used in determining dose equivalents for chest projections through 1985 .................... 88

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

lumbar spine and pelvis for all periods ................................................................................... 89

B-4 Skin dose guidance for chest projections for the poor collimation period through 1970.......... 90

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

period through 1970...............................................................................................................92

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

1970.......................................................................................................................................93

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

1970.......................................................................................................................................95

B-8 Skin dose guidance for chest projections for the good collimation period after 1970 .............. 96

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

1970.......................................................................................................................................97

B-10 Organ dose equivalents for chest projections for all periods................................................. 100

B-11 Skin dose equivalents from chest projections through 1970................................................. 103

B-12 Skin dose equivalents from various chest projections after 1970.......................................... 104

B-13 Organ dose equivalents for lumbar spine and pelvis projections for all periods .................... 106

B-14 Skin dose equivalent from lumbar spine and pelvis projections for all periods...................... 108

B-15 Organ dose equivalents for thoracic and cervical spine projections through 1970................ 110

B-16 Skin dose equivalent from thoracic and cervical spine projections through 1970.................. 113
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 87 of 114

Table B-1. DCFs used in determining dose equivalents from thoracic and cervical spine projections through 1970 (mGy/Gy × 10-3 remGy/cGy-mGy)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 7.00E-04 1.00E-04 Measuredb Measuredb

Colon rectum 7.00E-04 1.00E-04 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 3.67E-01 5.60E-03 1.50E-02 2.30E-02

Uterus 5.00E-04 1.00E-04 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)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 88 of 114

Table B-2. DCFs used in determining dose equivalents for chest projections through 1985 (mGy/Gy × 10-3 rem-Gy/cGy-mGy).

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-01 1.50E-01 1.74E-01 1.37E-01 8.68E-01c 3.20E-02 1.15E-01 3.17E-01

Eye/brain 3.20E-02 2.10E-02 3.20E-02 1.37E-01 8.68E-01c 3.20E-02 1.15E-01 3.17E-01

Ovaries Measuredd 6.00E-04 Measuredd Measuredd 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 

Measuredd 6.00E-04 Measuredd Measuredd 2.33E-01 1.00E-03 6.00E-04 2.00E-03

Colon 

rectum 

Measuredd 6.00E-04 Measuredd Measuredd 2.33E-01 1.00E-03 6.00E-04 2.00E-03

Testes Measuredd 1.00E-05 Measuredd Measuredd 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 Measuredd 7.00E-04 Measuredd Measuredd 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. Cervical spine Thyroid DCF used to account for poor collimation.

d. Measured means that a measured dose from literature is used rather than a DCF.
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 89 of 114

Table B-3. DCFs used in determining dose equivalents for chest projections 1986 and later, and for lumbar spine and pelvis for all periods 

(mGy/Gy × 10-3 rem-Gy/cGy-mGy).

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 and laterc

LAT 

lumbar spine 

1971 and laterc

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 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

Urinary bladder/prostate 5.20E-03 2.50E-03 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

Colon rectum 5.20E-03 2.50E-03 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

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 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

Bone surfaces 6.74E-01 3.51E-01 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

Remainder 6.74E-01 3.51E-01 1.60E-01 3.10E-02 2.16E-01 4.70E-02 1.74E-01

Breast 1.16E-01 3.43E-01 Derivede Derivede Derivede Derivede Derivede

Uterus 5.20E-03 2.10E-03 2.17E-01 2.00E-02 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. Used method from Huda and Bissessur (1990).
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 90 of 114

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 91 of 114

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: base of neck to midbackENSD 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

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)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 92 of 114

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
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

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

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.

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)
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 94 of 114

Area of skin

AP 

thoracic spine

through 1970

LAT 

thoracic spine

through 1970

RPO 

thoracic spine

through 1970

LPO 

thoracic spine

through 1970

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

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)
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 96 of 114

Area of skin

AP 

cervical spine 

through 1970

LAT 

cervical spine 

through 1970

RPO 

cervical spine 

through 1970

LPO 

cervical spine 

through 1970

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)

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).

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)
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 97 of 114

Area of skin

PA 

chest 

after 1970

LAT 

chest 

after 1970

AP lordotic 

chest 

after 1970

RAO 

chest 

after 1970

LAO 

chest 

after 1970

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

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.

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 98 of 114

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

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

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 99 of 114

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

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 

ORGAN DOSE EQUIVALENT TABLES (continued)

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Table B-10. Organ dose equivalents (rem) for chest projections for all periods.

a

Organ Projection

Through 

1970 1971–1985

After 

1985

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/OBL 6.85E-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

-02

d 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

-02

d 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

-02

d 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

-03

d 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)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 101 of 114

Organ Projection

Through 

1970 1971–1985

After 

1985

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 surfaceFluoroscopy

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)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 102 of 114

Organ Projection

Through 

1970 1971–1985

After 

1985

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

-02

d 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 1.35 and 1.42 for HVL of 2.5 mm Al and 4.0 mm Al, respectively, from NCRP Report 102 

(NRCP 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)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 103 of 114

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 6.85E-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 6.85E-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 6.85E-02 2.70E-01 6.75E-01 3.0E-03

Right side of face 7.25E-02 5.25E-02 6.4E-03 6.85E-02 2.70E-01 3.0E-03 6.75E-01

Left side of neck 3.06E-01 3.30E+00 2.70E-01 6.85E-02 2.70E-01 6.75E-01 3.0E-03

Right side of neck 3.06E-01 3.30E+00 2.70E-01 6.85E-02 2.70E-01 3.0E-03 6.75E-01

Back of head 3.06E-01 3.30E-01 2.70E-02 6.85E-02 5.9E-03 6.75E-02 6.75E-02

Front of neck 7.25E-02 5.25E-02 6.4E-03 6.85E-02 2.70E-01 6.85E-02 6.85E-02

Back of neck 3.06E-01 3.30E+00 2.70E-01 6.85E-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. 05 Effective Date: 08/13/2018 Page 104 of 114

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.

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 105 of 114

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

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

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 106 of 114

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

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.

Table B-13. Organ dose equivalents (rem) for lumbar spine and pelvis 

projections for all periods.

a,b

Organ Projection

Through 

1970

After 

1970

Thyroid AP or AP spot lumbar spinec 2.88E-04 2.33E-04

Thyroid LAT or LAT spot lumbar spined 3.79E-05 2.80E-05

Thyroid AP pelvis 1.52E-05 Not used

Eye/brain AP or AP spot lumbar spinec 2.88E-04 2.33E-04

Eye/brain LAT or LAT spot lumbar spined 3.79E-05 2.80E-05

Eye/brain AP pelvis 1.52E-05 Not used

Ovariesb AP or AP spot lumbar spinec 5.60E-01 1.68E-01

Ovaries LAT or LAT spot lumbar spined 7.10E-01 1.32E-01

Ovaries AP pelvis 6.50E-01 Not used

Urinary/bladder/prostatee AP or AP spot lumbar spinec 2.30E-01 1.68E-01

Urinary/bladder/prostate LAT or LAT spot lumbar spined 1.17E-01 1.32E-01

Urinary/bladder/prostate AP pelvis 2.64E-01 Not used

Colon/rectume AP or AP spot lumbar spinec 2.30E-01 1.68E-01

Colon/rectum LAT or LAT spot lumbar spined 1.17E-01 1.32E-01

Colon/rectum AP pelvis 2.64E-01 Not used

Testesb AP or AP spot lumbar spinec 2.70E-02 3.26E-03

Testes LAT or LAT spot lumbar spined 5.60E-02 2.24E-03

Testes AP pelvis 6.40E-01 Not used

Lungs (male) AP or AP spot lumbar spinec 8.93E-02 6.13E-02

Lungs (male) LAT or LAT spot lumbar spined 3.79E-02 3.92E-02

Lungs (male) AP pelvis 1.52E-03 Not used
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 107 of 114

Organ Projection

Through 

1970

After 

1970

Lungs (female) AP or AP spot lumbar spine

c 8.93

E-026.13E-02

Lungs (female) LAT or LAT spot lumbar spine

d 3.79

E-02 3.92E-02

Lungs (female) AP pelvis 1.52E-03 Not used

Thymus AP or AP spot lumbar spine

c 8.93

E-026.13E-02

Thymus LAT or LAT spot lumbar spine

d 3.79

E-02 3.92E-02

Thymus AP pelvis 1.52E-03 Not used

Esophagus AP or AP spot lumbar spine

c 8.93

E-026.13E-02

Esophagus LAT or LAT spot lumbar spine

d 3.79

E-02 3.92E-02

Esophagus AP pelvis 1.52E-03 Not used

Stomach

e AP or AP spot lumbar spinec 2.30

E-011.68E-01

Stomach LAT or LAT spot lumbar spine

d 1.17

E-01 1.32E-01

Stomach AP pelvis 2.64E-01 Not used

Bone surface

e AP or AP spot lumbar spinec 2.30

E-01 1.68E-01

Bone surface LAT or LAT spot lumbar spine

d 1.17

E-01 1.32E-01

Bone surfaceAP pelvis 2.64E-01 Not used

Liver/gallbladder/spleen

e AP or AP spot lumbar spinec 2.30

E-011.68E-01

Liver/gallbladder/spleen LAT or LAT spot lumbar spine

d 1.17

E-01 1.32E-01

Liver/gallbladder/spleen AP pelvis 2.64E-01 Not used

Remainder organs

e AP or AP spot lumbar spinec 2.30

E-011.68E-01

Remainder organs LAT or LAT spot lumbar spine

d 1.17

E-01 1.32E-01

Remainder organs AP pelvis 2.64E-01 Not used

Breast

f AP or AP spot lumbar spinec 4.78

E-03 9.56E-04

Breast LAT or LAT spot lumbar spine

d 7.58

E-03 2.07E-03

Breast AP pelvis 7.79E-03 Not used

Uterus AP or AP spot lumbar spine

c 3.12

E-012.23E-01

Uterus LAT or LAT spot lumbar spine

d 7.58

E-02 8.68E-02

Uterus AP pelvis 3.71E-01 Not used

Bone marrow (male) AP or AP spot lumbar spine

c 3.46

E-02 2.87E-02

Bone marrow (male) LAT or LAT spot lumbar spine

d 5.69

E-02 6.16E-02

Bone marrow (male) AP pelvis 3.50E-02 Not used

Bone marrow (female) AP or AP spot lumbar spine

c 3.46

E-02 2.87E-02

Bone marrow (female) LAT or LAT spot lumbar spine

d 5.69

E-02 6.16E-02

Bone marrow (female) AP pelvis 3.50E-02 Not used
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 108 of 114

Organ Projection

Through 

1970

After 

1970

Entrance sking AP or AP spot lumbar spinec 1.900E+00 1.05E+00

Entrance skin LAT or LAT spot lumbar spined 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 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.

f. Breast dose equivalents determined by using the method in Huda and Bissessur (1990).

g. Skin dose equivalents for all areas of skin are provided in Tables B-14. 

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 

after 1970

LAT or LAT spot 

lumbar spine 

after 1970

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 109 of 114

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 

after 1970

LAT or LAT spot 

lumbar spine 

after 1970

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

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. 05 Effective Date: 08/13/2018 Page 110 of 114

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 6.00

E-05

a

Ovaries LAT 4.60E-02

a LAT 2.00

E-04

a

Ovaries RPO 4.60E-02 RPO 6.00E-05

Ovaries LPO 4.60E-02 LPO 6.00E-05

Urinary/bladder/

prostate

AP 6.90E-04

c AP 6.00

E-05

Urinary/bladder/

prostate

LAT 2.20E-04

c LAT 2.0

0E-04

Urinary/bladder/

prostate

RPO 2.20E-04 RPO 6.00E-05

Urinary/bladder/

prostate

LPO 2.20E-04 LPO 6.00E-05

Colon/rectum AP 6.90E-04

c AP 6.00

E-05

Colon/rectum LAT 2.20E-04

c LAT 2.00

E-04

Colon/rectum RPO 2.20E-04 RPO 6.00E-05

Colon/rectum LPO 2.20E-04 LPO 6.00E-05

Testes AP 1.00E-03

a AP 2.70

E-04

a

Testes LAT 2.00E-03

a LAT 9.20

E-04

a

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 6.48

E-03

Lungs (male) LAT 2.35E-01

b LAT 5.98

E-03

Lungs (male) RPO 2.35E-01 RPO 6.48E-03

Lungs (male) LPO 2.35E-01 LPO 6.48E-03
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 111 of 114

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

Lungs (female) AP 2.33E-01

b AP 6.48

E-03

Lungs (female) LAT 2.82E-01

b LAT 5.98

E-03

Lungs (female) RPO 2.82E-01 RPO 6.48E-03

Lungs (female) LPO 2.82E-01 LPO 6.48E-03

Thymus AP 3.27E-01

b AP 6.48

E-03

Thymus LAT 2.82E-01

b LAT 5.98

E-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 6.48

E-03

Esophagus LAT 2.82E-01

b LAT 5.98

E-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 6.48

E-03

Stomach LAT 2.82E-01

b LAT 5.98

E-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 6.48

E-03

Bone surface LAT 2.82E-01

b LAT 5.98

E-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 6.48

E-03

Liver/gallbladder/

spleen

LAT 2.82E-01

b LAT 5.98

E-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 6.48

E-03

Remainder 

organs

LAT 2.82E-01

b LAT 5.98

E-03

Remainder 

organs

RPO 2.82E-01 RPO 6.48E-03
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 112 of 114

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

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 4.93E-04 AP 6.00E-05

a

Uterus LAT 2.20E-04 LAT 2.00E-04

a

Uterus RPO 2.20E-04 RPO 6.00E-05

Uterus LPO 2.20E-04LPO 6.00E-05

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 113 of 114

Organ

Thoracic 

spine 

projection

Organ dose 

equivalents 

(rem)

Cervical 

spine 

projection

Organ dose 

equivalents 

(rem)

Entrance skind AP 1.30E+00a AP 5.70E-01

Entrance skin LAT 2.90E+00a 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, and ovaries for the thoracic spine, and measured values 

(Braestrup and Wycoff 1958) 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. The ovary DCF is used to determine organ dose equivalents for the urinary bladder, 

prostate, colon, and rectum for projections of the thoracic spine.

d. Skin dose equivalents for all areas of skin are provided in Tables B-16. 

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
ATTACHMENT B 

ORGAN DOSE EQUIVALENT TABLES (continued)

Document No. ORAUT-OTIB-0006 Revision No. 05 Effective Date: 08/13/2018 Page 114 of 114

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

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

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.