The diagnostic reference levels (DRLs) have been established for an efficient administration of the radiation dose and for the optimization of the acquisition technique. Historically the DRLs were developed by imaging study, but not related to the clinical indication of the imaging study.

However even in the same anatomic region an allegedly optimized CT dose could not be adequate depending on the clinical indication. As an example, a lung CT study has a different protocol and radiation dose if the indication is a lung cancer, pulmonary embolism or lung metastasis. Thus, DRLs based single on a CT study of a given anatomic region is not a reasonable indicator for dose optimization if the clinical indication is not integrated.

Indeed the Eurosafe Imaging recommends both, the development of DRLs (Action 2) and image quality assessment based on clinical indications (Action3).

The aim of this communication is to describe how we develop the clinical DRLs for adults and children specific to the institution and the CT scanner manufacturer.