Background/introduction
Success of a diagnostic radiology examination does not only depend on dose optimization but even more on the appropriate image quality in order to answer the clinical question. Not every clinical question, even if it concerns the same anatomical region, requires the same image quality and the same radiation exposure. Therefore, clinical DRLs are a big step forward to help the users to optimize their indication-based protocols and should be made available by the competent authorities.
Description of activity and work performed
Swiss national DRLs for CT were updated in 2018 by collecting dose data of more than 220’000 examinations from 14 radiological institutes (50 CT scanners) between 2014 and 2017, all with locally installed dose management software systems [1]. A substantial dose reduction - average of 30% for the CTDI - was observed compared to the previous DRLs (2010). Five out of the 15 proposed CT protocols have a well-defined clinical indication: Low Dose Sinuses (Sinusitis), CT Angiography (Carotid Angio), CT Angiography (Exclusion PE), Exclusion of...
Conclusion and recommendations
Clinical DRLs provide accurate values for the different anatomical regions and are a good starting point for patient dose optimization. In order to improve patient safety and quality of care, the optimisation process must not only cover the dose aspects, but also the image quality. Therefore, DRLs should not only be based on clinical indications with corresponding dose indicators. Instead, the image quality requirements related to the clinical question must be defined in future too.
Personal/organisational information
B. Ott; Bundesamt für Gesundheit, Bern/CH - nothing to disclose R. Treier; Bundesamt für Gesundheit, Bern/CH - nothing to disclose Ph. R. Trueb; Bundesamt für Gesundheit, Bern/CH - nothing to disclose S. Baechler; Bundesam für Gesundheit, Bern/CH - nothing to disclose
References
[1] Aberle, C., Ryckx, N., Treier, R. et al. Eur Radiol (2019). Update of national diagnostic reference levels for adult CT in Switzerland and assessment of radiation dose reduction since 2010; https://doi.org/10.1007/s00330-019-06485-1
[2] ESR EuroSafe Imaging (2017) EUCLID - European study on clinical diagnostic reference levels for X-ray medical imaging. http://www.eurosafeimaging.org/euclid
(last access 24.1.2020)
[3] Federal Office of Public Health, Switzerland, Radiation Protection Division (2018) Directive R-06–06: Diagnostische Referenzwerte in der Computertomografie. https://www.bag.admin.ch/dam/bag/de/dokumente/str/std/bag-wegleitungen/2018-06-15-r-06-06.pdf.download.pdf/R-06-06wd.pdf
(last acess 24.1.2020)
[4] Dose optimization of abdominal CT protocols: Implementation of...
