"Diagnostic reference level" (DRL): Definitions
introduced in 1996 by the International Commission on Radiological Protection (ICRP) (1),
updated in 2017 regarding recommendations on DRLs in medical imaging and clarification issues related to definitions of the terms (2).
According to ICRP publication 135 (2):
National DRLs (NDRLs) are representative of an entire country,
Local DRLs (LDRLs) are representative of a few healthcare facilities in a local area.
They consider faster local optimization processes than NDRLs and remain anatomy-based.
NDRLs and LDRLs are calculated as the...
Description of activity and work performed
5 imaging centers of the Swiss Groupe 3R (3R,
Réseau Radiologique Romand) were involved in this study.
A dose-team was set-up,
with one radiologist and one technologist in each center,
a CT field engineer,
a physicist and team leader,
aiming at standardizing protocols,
optimizing dose while maintaining image quality and creating awareness and dissemination.
Image quality was assessed using adapted European image quality guidelines (4) ( Fig. 1 ) and through an electronic image quality voting button in the dose tracking software used...
Conclusion and recommendations
This prospective multicenter study on > 6'000 examinations shows:
BMI>25 patients are not outliers anymore (>50% of study population).
Large dose metrics variations between the BMI<25 and BMI>25 groups,
for chest and abdomen examinations.
Influence of clinical indication on dose metrics is more important in abdomen than in chest examinations.
Current limitation of adult DRL definition,
confined to representative standard patient.
In this respect,addressing clinical indication and patient BMI is very relevant when defining clinical DRLs for CT examinations.
Given the importance of dose...
Institut de Radiologie de Sion
Rue du Scex,
Mail : [email protected]
International Commission on Radiological Protection (1996) ICRP publication 73: Radiological Protection and Safety in Medicine.
ICRP 26 (2).
International Commission on Radiological Protection (2017) ICRP publication 135: Diagnostic reference levels in medical imaging.
ICRP 46 (1).
Morin RL (2017) U.S.
Diagnostic Reference Levels and Achievable Doses for 10 Adult CT Examinations.
Federal Office of Public Health (2018) Directive R-06-06 Niveaux de référence diagnostiques en tomodensitométrie.
Available via https://www.bag.admin.ch/dam/bag/fr/dokumente/str/std/bag-wegleitungen/2018-06-15-r-06-06.pdf.
Accessed 13 October...