Congress:
EuroSafe Imaging 2019
Keywords:
Action 2 - Clinical diagnostic reference levels (DRLs), Radioprotection / Radiation dose, Radiographers, CT, Dosimetry, Safety, Radiation safety, Dosimetric comparison
Authors:
M. Ferderbar, J. Castelli, D. Koff
DOI:
10.26044/esi2019/ESI-0051
Background/introduction
The International Committee on Radiological Protection (ICRP) promotes the As Low As Reasonably Achievable (ALARA) principle as a guideline for diagnostic imaging [1].
If one follows this principle,
the effects associated with imaging can be minimized.
However,
it is difficult to know what the lowest level could be.
By using radiation dose monitoring,
clinicians,
physicists,
technologists,
and other health care professionals could ensure that the ALARA principle is adhered to throughout the diagnostic imaging process [2].
A good way to quantify this would be through the use of a Diagnostic Reference Level (DRL),
especially in computed tomography (CT) [3].
DRLs can be set to guide CT imaging.
For any given protocol,
DRLs can be set by using the third quartile dose-length product (DLP) (75th percentile) to identify exams that are above the median level [4].
The mean value (50th percentile) is considered an achievable value,
but the 75th percentile is a good starting point [5].
It is important to remember that the DRL is not an optimal level; it is a level that can be used to identify unusual practice and set a standard of care.
Recently,
Health Canada,
the national public health department in Canada,
published the 2016 Health Canada Canadian Computed Tomography Dose Survey (referred to as HC13 because the final year of data collection was 2013) [6].
The gap identified in the Health Canada survey was a lack of province-specific DRLs.
Therefore,
this poster was created to exhibit and compare the provincial DRLs for the top three most common scans in Canada,
which are abdomen/pelvis (47.4%),
head/brain (27.3%),
and chest (14.5%) [7].