Adult patient radiation doses from non-cardiac CT examinations: a review of published results

Abstract

The introduction of mechanisms for dose reduction resulted in significantly lower patient effective doses for CT examinations of the head, chest and abdomen reported by studies published after 1995. Owing to the limited number of studies reporting patient doses for multislice CT examinations the statistical power to detect differences with single-slice scanners is not yet adequate.

Radiation Doses in Consecutive CT Examinations from Five University of California Medical Centers

“…However, few CT diagnostic reference levels in the United States are based on large numbers of actual patient examinations; many U.S. guidelines are based on selected data submitted to demonstrate a facility's best work (10)(11)(12), and these may not reflect the routine radiation doses to which patients are exposed. In contrast, guidelines and reference levels have been created in Europe to standardize CT radiation doses (13)(14)(15)(16)(17)(18).…”

“…Our data, organized according to anatomic region, offer a practical way to compare CT dose levels across institutions and patients, and this approach has been used in other countries to compare practice (16)(17)(18). U.S. national efforts on creating CT dose-level benchmarks have primarily used survey data in which institutions report typical scanning parameters.…”

“…For example, facilities applying (12). In contrast, there are considerable data and benchmarks from European countries with which to compare our data (13)(14)(15)(16)(17)(18). As reference levels are typically set at the 75% level, we use the data presented in Table 3 to compare with these European publications.…”

“…The median DLPs for single-phase, multiphase, and all examinations, respectively, were as follows: head, 880 mGy · cm (IQR, 640-1120 mGy · cm), 1550 mGy · cm (IQR, 1150-2130 mGy · cm), and 960 mGy · cm (IQR, 690-1300 mGy · cm); chest, 420 mGy · cm (IQR, 260-610 mGy · cm), 880 mGy · cm (IQR, 570-1430 mGy · cm), and 550 mGy · cm (IQR 320-830 mGy · cm); and abdomen, 580 mGy · cm (IQR, 360-860 mGy · cm), 1220 mGy · cm (IQR, 850-1790 mGy · cm), and 960 mGy · cm (IQR, 600-1460 mGy · cm). Median effective doses for single-phase, multiphase, and all examinations, respectively, were as follows: head, 2 mSv (IQR, 1-3 mSv), 4 mSv (IQR, 3-8 mSv), and 2 mSv (IQR, 2-3 mSv); chest, 9 mSv (IQR, 5-13 mSv), 18 mSv (IQR, 12-29 mSv), and 11 mSv (IQR, 6-18 mSv); and abdomen, 10 mSv (IQR, 6-16 mSv), 22 mSv (IQR, 15-32 mSv), and 17 mSv (IQR,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). In general, values for children were approximately 50% those for adults in the head and 25% those for adults in the chest and abdomen.…”

The establishment of computed tomography diagnostic reference levels in Portugal

“…Limiting the range of CT scanning just to the relevant region of interest is one of the simplest ways to limit the radiation exposure of patients and should be encouraged (36) . It should be emphasised that although helical technology possesses the potential to easily extend scan ranges, routine use can lead to unjustifiable patient doses (37) .…”