Establishment of regional Diagnostic Reference Levels (DRLs) for digital mammography in western region of Sri Lanka

2020 ◽  
Author(s):  
H S Niroshani ◽  
Jeyasingam Jeyasugiththan ◽  
Gayani Senanayake ◽  
Toru Negishi
Keyword(s):  
Sri Lanka ◽  
Digital Mammography ◽  
Western Region ◽  
Diagnostic Reference Levels ◽  
Reference Levels

Diagnostic reference levels for digital mammography in New South Wales

2016 ◽  
Vol 61 (1) ◽  
pp. 48-57 ◽  
Author(s):  
Moayyad E Suleiman ◽  
Mark F McEntee ◽  
Lucy Cartwright ◽  
Jennifer Diffey ◽  
Patrick C Brennan
Keyword(s):  
Digital Mammography ◽  
New South ◽  
New South Wales ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
South Wales

Diagnostic reference levels in digital mammography: a systematic review

2014 ◽  
Vol 167 (4) ◽  
pp. 608-619 ◽  
Author(s):  
Moayyad E. Suleiman ◽  
Patrick C. Brennan ◽  
Mark F. McEntee
Keyword(s):  
Systematic Review ◽  
Digital Mammography ◽  
Diagnostic Reference Levels ◽  
Reference Levels

Establishment of national diagnostic reference levels (NDRL) for computed tomographic (CT) procedures in Sri Lanka: first nation-wide dose survey

2021 ◽  
Author(s):  
T Amalaraj ◽  
Duminda Satharasinghe ◽  
Aruna Pallewatte ◽  
Jeyasingam Jeyasugiththan
Keyword(s):  
Sri Lanka ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Standard Size ◽  
Dose Length Product ◽  
Computed Tomographic ◽  
Ct Dose ◽  
Contrast Enhanced ◽  
Ct Dose Index ◽  
First Time

Abstract The main purpose of this study was to establish the national diagnostic reference levels (NDRLs) for common CT procedures for the first time in Sri Lanka. Patient morphometric, exposure parameters, and dose data such as volume CT dose index (CTDIvol) and dose length product (DLP) were collected from 5666 patients who underwent 22 procedure types. The extreme dose values were filteblue before analysis to ensure that the data comes from standard size patients. The median of the dose distribution was calculated for each institution, and the third quartile value of the median distribution was consideblue as the NDRL. Based on the inclusion and exclusion criteria, 4592 patients data from 17 procedure types were consideblue for NDRL establishment covering 41\% of the country's total CT machines. The proposed NDRLs based on CTDIvol and DLP for non-contrast (NC) head:82.2 mGy/1556 mGy.cm, contrast-enhanced (CE) head: 82.2 mGy/1546 mGy.cm, chest-NC:7.4 mGy/350 mGy.cm, chest-CE:8.3 mGy/464 mGy.cm, abdomen NC:10.5 mGy/721 mGy.cm, abdomen arterial (A) phase:13.4 mGy/398 mGy.cm, abdomen venous (V) phase:10.8 mGy/460 mGy.cm, abdomen delay (D) phase:12.6 mGy/487 mGy.cm, sinus NC:30.2 mGy/452 mGy.cm, lumbar spine--NC:24.1 mGy/1123 mGy.cm, neck-NC:27.5 mGy/670 mGy.cm, high resolutions CT (HRCT) of chest:10.3 mGy/341 mGy.cm, kidney, ureter and bladder (KUB) NC:19.4 mGy/929 mGy.cm, chest to pelvis (CAP) NC:10.8 mGy/801 mGy.cm, CAP-A:10.4 mGy/384 mGy.cm, CAP-V:10.5 mGy/534 mGy.cm and CAP-D:16.8 mGy/652 mGy.cm. Although the proposed NDRLs are comparable with other countries, the observed broad dose distributions between the CT machines within the country indicate that dose optimisation strategies for Sri Lanka should be implemented for most of the CT facilities.

Diagnostic reference levels in digital mammography: A systematic review

2021 ◽  
Author(s):  
Qiumei Liu ◽  
Moayyad E Suleiman ◽  
Mark F McEntee ◽  
BaoLin P Soh
Keyword(s):  
Systematic Review ◽  
Digital Mammography ◽  
Standard Dose ◽  
Dose Calculation ◽  
Future Research ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Monitoring ◽  
Data Source ◽  
Guidelines And Recommendations

Abstract Diagnostic reference levels (DRLs) in digital mammography (DM) serve as a useful benchmark for dose monitoring and optimization, allowing comparison amongst countries, institutions and mammography units. A systematic review of DRLs in DM, published in 2014, reported a lack of consistent and internationally accepted protocol in DRLs establishment, thereby resulting in wide variations in methodologies which complicates comparability between studies. In 2017, the International Commission of Radiation Protection (ICRP) published additional guidelines and recommendations to provide clarity in the protocol used in DRLs establishment. With the continuing evolvement of technology, optimization of examinations and updates in guidelines and recommendations, DRLs should be revised at regular intervals. This systematic review aims to provide an update and identify a more consistent protocol in the methodologies used to establish DRLs. Searches were conducted through Web of Science, PubMed-MEDLINE, ScienceDirect, CINAHL and Google Scholar, which resulted in 766 articles, of which 19 articles were included after screening. Relevant data from the included studies were summarized and analyzed. While the additional guidelines and recommendations have provided clarifications in the methodologies used in DRLs establishment, such as data source (i.e., the preference to use data derived from patient instead of phantoms to establish DRLs), protocol (i.e., stratification of DRLs by compressed breast thickness and detector technology, and the use of median value for DRLs quantity instead of mean) and percentiles used to establish DRLs (i.e., set at the 75th percentile with a minimum sample size of 50 patients), other differences such as the lack of a standard dose calculation method used to estimate mean glandular dose continues to complicate comparisons between studies and different DM systems. This systematic review update incorporated the updated guidelines and recommendations from ICRP which will serve as a useful resource for future research efforts related to DRLs, dose monitoring and optimization.

New french diagnostic reference levels: Let's take stock of our daily practices!

2019 ◽  
Vol 46 (6) ◽  
pp. 341-342 ◽  
Author(s):  
Julien Ognard ◽  
David Bourhis ◽  
René Anxionnat ◽  
Douraied Ben Salem
Keyword(s):  
Diagnostic Reference Levels ◽  
Reference Levels

Diagnostic Reference Levels for Common Orthopedic Hand and Wrist Procedures Using Intraoperative mini C-arm Fluoroscopy

Hand ◽  
2021 ◽  
pp. 155894472199425
Author(s):  
Kiran R. Madhvani ◽  
Matthew J. R. Clark ◽  
Alex A. J. Kocheta
Keyword(s):  
Radiation Dose ◽  
Fracture Fixation ◽  
Wrist Fracture ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Audit Data ◽  
Small Joint ◽  
Open Fixation ◽  
Phalangeal Fracture

Background: Diagnostic reference levels are radiation dose levels in medical radiodiagnostic practices for typical examinations for groups of standard-sized individuals for broadly defined types of equipment. This study aimed to contribute to national diagnostic reference levels for common hand and wrist procedures using mini C-arm fluoroscopy. Small joint and digital fracture procedure diagnostic reference levels have not been reported in significant numbers previously with procedure-level stratification. Methods: Data were collected from fluoroscopy logbooks and were cross-referenced against the audit log kept on fluoroscopy machines. A total of 603 procedures were included. Results: The median radiation dose for wrist fracture open fixation was 2.73 cGycm2, Kirschner wiring (K-wiring) procedures was 2.36 cGycm2, small joint arthrodesis was 1.20 cGycm2, small joint injections was 0.58 cGycm2, and phalangeal fracture fixation was 1.05 cGycm2. Conclusions: Wrist fracture fixation used higher radiation doses than phalangeal fracture fixation, arthrodeses, and injections. Injections used significantly less radiation than the other procedures. There are significant differences in total radiation doses when comparing these procedures in hand and wrist surgery. National and international recommendations are that institutional audit data should be collected regularly and should be stratified by procedure type. This study helps to define standards for this activity by adding to the data available for wrist fracture diagnostic reference levels and defining standards for digital and injection procedures.

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