Diagnostic reference levels (DRLs) are one of the tools currently used to optimize patient dose in medical imaging.
First introduced by the International Commission on Radiological Protection (ICRP) in 1996,
this concept has been used by international,
European and national guidance and regulations.
In the medical imaging field,
where no dose limit applies to patient exposure,
DRLs are used to indicate to radiologists and radiographers whether,
for a standard procedure and a standard morphotype,
the patient dose is abnormally high or not.
First DRLs have...
Description of activity and work performed
any institution with a medical imaging facility must annually evaluate the doses delivered for two types of examination and for 30 patients per examination.These data have to be compared to the applicable DRLs and to be transmitted to IRSN using a dedicated web site.This requirement allows professionals to implement a dose optimization approach and the public authorities to update theDRL values.
The analysis of the 2013-2015 data shows a decrease by 10% on average in conventional radiology and by 15% in CT,
Conclusion and recommendations
French DRLs tables are regularly updated to be in accordance with technical progress and improvement of practice.
the analysis carried out by the IRSN showed that collected data in some centres were far below the previous DRLs.
in agreement with the new ICRP publication (pub.
the coming regulations will propose an optimization indicator (“Diagnostic Guide Value,
defined as the 50th percentile of data distribution) in addition to existing DRLs (75th percentile).
the DRL should be considered as an alert...
Institut de Radioprotection et de Sûreté Nucléaire (IRSN): 31,
avenue de la Division Leclerc - 92260 Fontenay-aux-Roses - France
Société Française de Radiologie (SFR): 47 rue de la Colonie - 75013 Paris - France
Using diagnostic reference levels to evaluate the improvement of patient dose optimisation and the influence of recent technologies in radiography and computed tomography.
European Journal of Radiology 98 (2018) 68–74.
Patient dose in interventional radiology: a multicenter study of the most frequent procedures in France.
Eur Radiol (2017) 27:4281–4290.
Patient exposure from nuclear medicine in...