Dose Reference Levels (DRLs) are used in Medical Imaging clinical routine to indicate whether the dose to the patient is unusually high or low for a specific procedure and they are typically defined for anatomical regions.
The typicalDRL quantityisvolume CT dose index (CTDIvol),which isastandardized dose measurement in homogeneousphantomsand does notaccount for patient size.
Recently, the International Commission on Radiological Protection (ICRP)publication 135 (1) stressed the importance of clinical DRLs (CDRLs) to define more specific dose levels according to the needed image quality for a...
Description of activity and work performed
Purpose: The aim of this study was to compare CTDIvol to SSDE as CDRL quantity, in adult chest and abdomen examinations.
Data collection: From February 2017 to June 2018, after protocol optimization according to clinical indication and BMI class (< 25; ≥ 25), 5310 abdomen and 1058 chest CT series were collected from 5 CT scanners in a multicenter group (Table 1).
The 11 most recurrent clinical indications for chest and abdomen examinations represented 70% of all referred indications.
Study population (Fig. 1)
Conclusion and recommendations
For overweight adult chest and abdominal CT examinations, representing the majority of our patient population, CDRLs based on SSDE are comparable to CTDIvol.
For underweight patient, they arehigher.
This suggests thatusingSSDE as DRL metrics instead of CTDIvol could be more accurate for CDRLs definition anddose optimization.
Yet, they need to become readily available and established as a reference for DRL quantities and replace CTDIvol.
H. Brat; Sion/CH - nothing to disclose
Mail : firstname.lastname@example.org
P. Pujadas; Paris/FR - nothing to disclose
B. Rizk; Villars-sur-Glane/CH - nothing to disclose
D. Fournier; Sion/CH - nothing to disclose
F. Zanca; Heverlee/BE - nothing to disclose
B. Dufour; Sion/CH - nothing to disclose
International Commission on Radiological Protection (2017) ICRP publication 135: Diagnostic reference levels in medical imaging. Ann. ICRP 46 (1).
Brat H, Zanca F, Montandon S, Racine D, Rizk B, Meicher E, Fournier D. Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study. Eur Radiol. 2019 Dec;29(12):6794-6804.
AAPM report 204: https://www.aapm.org/pubs/reports/detail.asp?docid=143. Accessed 10 January 2020.
General references on DRLs
Kanal KM, Butler PF, Sengupta D, Bhargavan-Chatfield M, Coombs...