Prospective multicenter study on DRLs comparison according to clinical indication and anatomical region. Intermediate results.

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0039

Type:

EuroSafe Imaging

Keywords:

CT, Thorax, Abdomen, Action 13 - Stakeholder engagement and collaboration, Action 2 - Clinical diagnostic reference levels (DRLs), Action 10 - Improved communication and collaboration of health professionals in radiation protection, Action 3 - Optimisation, diagnostic reference levels, image quality, Diagnostic procedure, Dosimetric comparison

Authors:

H. Brat, F. Zanca, S. Montandon, C. Thouly, C. Dias, D. Fournier, S. Imsand

DOI:

10.1594/esi2017/ESI-0039

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0039

Fig. 3: Institutional anatomy vs National anatomy for BMI<25 patients.

Fig. 2: Institutional anatomy vs National anatomy for total study population.

Fig. 4: Institutional anatomy vs National anatomy for BMI>25 patients.

Background/Introduction

How can we improve patient's X-ray exposure, given that most countries have their own DRLs: with huge differences in terms of values when comparing countries besides they are few and always linked to anatomical regions There is clearly a lack of harmonization, which doesn’t help optimization. Actual DRLs mean same values for a liver tumor and for a kidney stone: it’s an abdomen CT DRL. Obviously, there is awareness that this is insufficient for initiating Dose Optimization especially if you want to relate it to...

Description of activity and work performed

Material and Methods : Our Material consists of national DRLs, 7 CT Scanners in 5 imaging centers of the same institution (Groupe 3R, Switzerland) and 22 Radiologists. All CT Scanners are connected to a single Dose Management Software (Dosewatch®), with parameter uniformization and protocol Radlex mapping occurring before data collection. Regarding protocol harmonization, we designed an indication-based protocol map with 2 categories of patients for each protocol according to Body Mass Index (BMI < 25 and BMI > 25). Protocol parameters have been harmonized according...

Conclusion and Recommendations

Conclusion: The purpose of this study was to compare diagnostic reference levels (DRLs) for CT examinations when using clinical indication versus anatomical region protocols according to patients BMI. 1. After protocol harmonisation, anatomy-based and indication-based institutional DRLs were: Significantly lower than national abdomen P25 DRLs in BMI<25 patients Significantly lower than national chest P75 DRLs in BMI<25 patients Significantly lower than national abdomen and chest P75 DRLs in BMI>25 patients 2. This study showed: a statistically significant impact in patient X-ray exposure reduction when considering...

Personal/Organisational information

Hugues Brat, MD Institut de Radiologie de Sion, IRS [email protected] Nothing to disclose Federica Zanca, PhD, Medical Physicist Chief scientist Dosewatch GE Healthcare [email protected] Nothing to disclose

References

1. Aalokken TM, Kristiansen J, Günther A, et al. Does iterative reconstruction in chest CT mean goodbye to chest radiographs? A comparison of diagnostic information, radiation dose and time consumption between ultra low dose CT and conventional chest radiography. Presented at: Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25-30, 2012, Chicago, IL 2. Frush DP, Applegate K. Computed tomography and radiation: understanding the issues. J Am Coll Radiol 2004;1(2):113-119. 3. Hanna WC, Paul NS, Darling GE, et al. Minimal-dose computed...