A study to establish diagnostic reference levels and achievable doses in the most frequent diagnostic radiology examinations in Croatia

Congress:

EuroSafe Imaging 2018

Poster Number:

ESI-0054

Type:

EuroSafe Imaging

Keywords:

CT, Mammography, Dosimetry, Physics, Radiation safety, Conventional radiography, Radioprotection / Radiation dose, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Quality assurance

Authors:

I. Kralik, B. Brkljacic, G. Ivanac, S. Medakovic, J. Popic, T. Salha, D. Stimac, T. Turk, D. Faj

DOI:

10.1594/esi2018/ESI-0054

DOI-Link:

https://dx.doi.org/10.1594/esi2018/ESI-0054

Fig. 1: DRLs given in ESD (blue columns) and achievable doses (red columns) for each...

Fig. 2: DRLs given in CTDIvol (blue columns) and achievable doses (red columns) for...

Fig. 3: DRLs given in DLP (blue columns) and achievable doses (red columns) for each...

Fig. 4: DRLs given in DAP (blue columns) and achievable doses (red columns) for each...

Fig. 5: DRL given in MGD (blue column) compared with European practice for mammography...

Fig. 6: DRL given in DAP (blue column) and achievable dose (red column) for PCI as well...

Background/introduction

As required by new EU BSS directive, diagnostic reference levels for radiodiagnostic examinations and interventional radiology procedures, where appropriate, shall be established, regularly reviewed and used for the purpose of optimisation [1]. This study was initiated by Croatian regulatory authority with the aim of establishment of national DRLs for most frequent diagnostic radiology examinations and investigate achievable doses. Study was conducted as a joint activity of regulatory authority staff, medical physics experts, radiologists and statisticians.

Description of activity and work performed

List of most frequent diagnostic radiology examinations was determined and it contained „Top 20 examinations“ according to DDMED2 project approach [2]. In addition, CT angiography procedures were included in the list as it can be seen from Table 1. For each type of examination, dose quantities were identified and are listed in the same table. Since there is no central patient dose registry in Croatia, for each type of examination dedicated questionnaires intended for collection of typical exposure parameters and doses were developed and sent...

Conclusion and recommendations

Though national DRLs and typical doses are in the range of published European values for most of the radiology procedures included in the survey, large variations in practice and doses were found making thus basis for further analysis. National DRLs should be established to raise awareness of patient doses in diagnostic and interventional radiology. An optimization of radiology practice should be initiated to reduce the variations in practice.

Personal/organisational information

[email protected]

References

[1] COUNCIL DIRECTIVE 2013/59/EURATOM of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom [2] European Commission. European guidance on estimating population doses from medical X-ray procedures. Radiation protection No 154. Brussels:EC. 2008 [3] Vassileva J, Rehani M. Diagnostic Reference Levels. American Journal of Roentgenology. 2015;204: W1-W3. 10.2214/AJR.14.12794 [4] ICRP, 2017. Diagnostic reference levels in medical imaging. ICRP Publication 135. Ann. ICRP 46(1) [5] European Commission....