Poor practice and governance in Lebanese national diagnostic reference levels of adult head and body computed tomography: A nationwide study

In Morocco, the radiation doses received by adult patients are increasing due to the number of CT examinations performed and the larger number of computed tomography (CT) scanners installed. The aim of this study was to evaluate the radiation doses received by patients for the most common adult CT examinations in order to establish local diagnostic reference levels (DRLs). Data from 1016 adult patients were collected during 3 months from four Moroccan hospitals. Dose length product (DLP) and volumetric computed tomography dose index (CTDIvol) were evaluated by determining the 75th percentile as diagnostic reference levels for the most common examinations including head, chest and abdomen. The DRL for each examination was compared with other studies. The established DRLs in Morocco in terms of CTDIvol were 57.4, 12.3 and 10.9 for CT examinations of the head, chest, abdomen, respectively. For DLP, they were 1020, 632 and 714, respectively. These established DRLs for CTDIvol were almost similar to the UK DRLs at all examinations, higher than the Egyptian DRLs and lower than the Japanese DRLs at the head CT examination, lower than the DRLs from Egypt and Japan at the CT abdomen examination. In terms of DLP, the DRLs were higher than those of the British studies, lower than those of the Egyptian and Japanese studies at the head CT examination were higher at chest CT and lower at abdominal CT than those of all selected studies. The higher level of established DRLs in our study demonstrates the requirement of an optimization process while keeping a good image quality for a reliable diagnosis.

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Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt

Physica Medica ◽

10.1016/j.ejmp.2017.05.050 ◽

2017 ◽

Vol 39 ◽

pp. 16-24 ◽

Cited By ~ 15

Author(s):

Dina Husseiny Salama ◽

Jenia Vassileva ◽

Gamal Mahdaly ◽

Mona Shawki ◽

Ahmad Salama ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Reference Levels ◽

Reference Levels

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ESTABLISHING DIAGNOSTIC REFERENCE LEVELS FOR CARDIAC COMPUTED TOMOGRAPHY ANGIOGRAPHY IN SAUDI ARABIA

Radiation Protection Dosimetry ◽

10.1093/rpd/ncx306 ◽

2018 ◽

Vol 181 (2) ◽

pp. 129-134 ◽

Cited By ~ 1

Author(s):

Ali B Alhailiy ◽

Peter L Kench ◽

Mark F McEntee ◽

Patrick C Brennan ◽

Elaine A Ryan

Keyword(s):

Computed Tomography ◽

Saudi Arabia ◽

Computed Tomography Angiography ◽

Cardiac Computed Tomography ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Cardiac Computed Tomography Angiography

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Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University ◽

10.48036/apims.v17i3.511 ◽

2021 ◽

Vol 17 (3) ◽

pp. 216-221

Author(s):

Fawad Yasin ◽

Anum Rasheed ◽

Muhammad Nauman Malik ◽

Farheen Raza ◽

Ramish Riaz ◽

...

Keyword(s):

Computed Tomography ◽

Radiation Dose ◽

European Commission ◽

Large Scale ◽

Radiology Department ◽

Radiation Doses ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Dose Length Product ◽

Ct Dose

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length

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Computed tomography diagnostic reference levels for adult brain, chest and abdominal examinations: A systematic review

Radiography ◽

10.1016/j.radi.2020.08.011 ◽

2020 ◽

Author(s):

I. Garba ◽

F. Zarb ◽

M.F. McEntee ◽

S.G. Fabri

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Adult Brain ◽

Diagnostic Reference Levels ◽

Reference Levels

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A systematic review on the current status of adult diagnostic reference levels in head, chest and abdominopelvic Computed Tomography

Journal of Radiological Protection ◽

10.1088/1361-6498/ab826f ◽

2020 ◽

Vol 40 (3) ◽

pp. R71-R98

Author(s):

Mohamad Fawzi Awad ◽

Lina Karout ◽

Ghida Arnous ◽

Mohammad Ahmmad Rawashdeh ◽

Layal Hneiny ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Current Status ◽

Diagnostic Reference Levels ◽

Reference Levels

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SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

Medical Physics ◽

10.1118/1.4923942 ◽

2015 ◽

Vol 42 (6Part4) ◽

pp. 3228-3228

Author(s):

H Wang ◽

Y Wang ◽

H Weng

Keyword(s):

Computed Tomography ◽

Body Weight ◽

Diagnostic Reference Levels ◽

Reference Levels

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ADULT CT EXAMINATIONS IN ALGERIA: TOWARDS UPDATING NATIONAL DIAGNOSTIC REFERENCE LEVELS

Radiation Protection Dosimetry ◽

10.1093/rpd/ncaa116 ◽

2020 ◽

Vol 190 (4) ◽

pp. 364-371

Author(s):

Nadia Khelassi-Toutaoui ◽

Ahmed Merad ◽

Virginia Tsapaki ◽

Fouzia Meddad ◽

Zakia Sakhri-Brahimi ◽

...

Keyword(s):

Computed Tomography ◽

Radiation Doses ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Dose Length Product ◽

Institutional Evaluation ◽

Starting Point ◽

First Results ◽

Ct Radiation ◽

Computed Tomography Dose Index

Abstract A pilot study has concerned the most frequent computed tomography examinations (CT). This represents the first results based on actual survey for diagnostic reference levels (DRLs) establishment in Algeria. A total number of 2540 patients underwent this survey that has included the recording of CT parameters, computed tomography dose index (CTDIvol) and dose-length product of the head, thorax, abdomen, abdomen–pelvis (AP), lumbar spine (LS) and thorax–abdomen–pelvis (TAP) performed on standard patients. The proposed DRLs are 71 mGy/1282 mGy.cm for head, 16 mGy/555 mGy.cm for thorax, 18 mGy/671 mGy.cm for abdomen, 21 mGy/950 mGy.cm for AP, 36 mGy/957 mGy.cm for LS and 18 mGy/994 mGy.cm for TAP. The rounded 75th percentile seems to be higher in some examinations compared to the literature. Our findings confirm the need to optimise our practice. These results provide a starting point for institutional evaluation of CT radiation doses.

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