Australian diagnostic reference levels for multi detector computed tomography

Hayton, Anna; Wallace, Anthony; Marks, Paul; Edmonds, Keith; Tingey, David T.; Johnston, Peter

doi:10.1007/s13246-013-0180-6

Cited by 35 publications

(27 citation statements)

References 7 publications

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“…Figure 4 and Table 2 show that the post-intervention maximum DLP is some two times the minimum, whereas considerably larger values have been observed elsewhere. 12,15,16 For example, a recent study of CT doses in Ireland shows the same 75th percentile as that observed in this study and a very similar minimum DLP, but the maximum is 50% higher than that observed here, the ratio of minimum to maximum being approximately 3.5. Full paper: CT CAP doses in Scotland: has the DRL had its day?…”

Section: Discussionsupporting

confidence: 85%

“…Data collected in the 2003 NRPB review 11 for CT CAP examinations and which provided the existing UK DRL of 940 mGy cm, using data from 36 multislice scanners, demonstrate such a distribution of data. Two recent publications that describe the dose distributions obtained in national data collections of CT data 12,15 -and which used sample sizes broadly similar to that used here-have shown distributions of CT dose data that are positively skewed and are not dissimilar in shape to those obtained in the 2003 review. This is most definitely not the case with the data collected in this study.…”

Section: Discussionmentioning

confidence: 77%

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CT chest abdomen pelvis doses in Scotland: has the DRL had its day?

Sutton

McVey

Gentle

et al. 2014

BJR

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Objective: This article reports on a pilot study designed to collect dose data representative of current CT chest abdomen pelvis (CAP) practice in Scotland, make any immediately obvious interventions and to identify if the current UK diagnostic reference level (DRL) of 940 mGy cm is still appropriate. The aims are to identify if a Scotland-wide picture archiving and communication system (PACS)-based dose audit of a number of CT examinations is likely to have value in terms of optimization of patient doses and to comment on the significance of the results in terms of future optimization strategies. Methods: Dose audit of CT CAP examinations at 32 different scanner sites across Scotland using accepted data collection and analysis methods. The minimum sample size was 30. Results: Results indicate that CT CAP doses are lower than those previously reported (median, 800 mGy cm, 75th percentile 840 mGy cm) but follow a distribution that is not in keeping with the concept of DRLs as presently understood or implemented. Conclusion: There is value in a PACS-based dose audit project to provide serial snapshots of patient doses as optimization efforts take place and to revise current knowledge about CT doses. In our opinion, the results call into question whether DRLs or the concept of "achievable dose" are suitable for devising optimization strategies once a certain degree of optimization has taken place. Advances in knowledge:The results reported here suggest that it may be time to take a different approach to optimization, concentrating on tools that are more refined than the DRL, which may have become more of a compliance tool than an aid to optimization.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 77%

CT chest abdomen pelvis doses in Scotland: has the DRL had its day?

Sutton

McVey

Gentle

et al. 2014

BJR

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“…contrast, number of phases, technique factors, reconstruction method and dose modulation information). The details of the service have been described in a previous publication . As a quality improvement activity, this project was exempt from research ethics approval.…”

Section: Methodsmentioning

confidence: 99%

“…Since the first publication of the Australian NDRLs for adult MDCT in 2012, MDCT technologies have changed significantly and together with dose optimisation initiatives, this necessitated a review of the Australian NDRLs. In addition, the International Commission on Radiological Protection (ICRP) recommends that NDRLs should be reviewed at regular intervals (3–5 years) .…”

Section: Introductionmentioning

confidence: 99%

Updated Australian diagnostic reference levels for adult CT

Lee¹,

Beveridge²,

Sanagou³

et al. 2020

J of Medical Radiation Sci

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Introduction In 2018, ARPANSA published updated national DRLs for adult CT, which were first published in 2012, and augmented the national DRL categories. This paper presents the updated national DRLs and describes the process by which they were produced. Methods Examine patient survey data submitted to the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) National Diagnostic Reference Level Service (NDRLS). Determine the quartiles of the distributions of median survey dose metrics with categorisation by procedure type. Engage a liaison panel representing the radiology professions to review procedure categories and recommend revised national DRLs. The revised NDRL procedure categories are: head (non‐contrast brain (trauma/headache)), cervical spine (Non‐contrast (trauma)), soft‐tissue neck (post‐contrast (oncology)), chest (post‐contrast (oncology)), abdomen–pelvis (post‐contrast (oncology)), kidney–ureter–bladder (non‐contrast (suspected renal colic)), chest–abdomen–pelvis (post‐contrast (oncology)) and lumbar spine (non‐contrast (degenerative pain)). Results The existing six procedure categories were revised and refined. Updated Australian national diagnostic reference levels for adult CT were recommended and endorsed for eight procedure categories: head (52 mGy/880 mGycm), cervical spine (23 mGy/470 mGycm),soft‐tissue neck (17 mGy/450 mGycm), chest (10 mGy/390 mGycm), abdomen–pelvis (13 mGy/600 mGycm), kidney–ureter–bladder (13 mGy/600 mGycm), chest–abdomen–pelvis (11 mGy/940 mGycm) and lumbar spine (26 mGy/670 mGycm). The updated national DRLs are between 12 and 26% lower than the previous DRLs for dose‐length product and between 13 and 63% lower for volume computed tomography dose index. Conclusions Australian national DRLs for adult CT have been reviewed and revised. The revised national DRLs are lower, better reflecting current practice among imaging facilities in Australia. The revised Australian national DRLs are similar to those in other developed countries.

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“…As part of this project, ARPANSA has hosted a database and internet data portal for the National Diagnostic Reference Level Service (NDRLS). 4 The NDRLS enables diagnostic radiology facilities to meet their obligations under the Code of Practice for Radiation in the Medical Applications of Ionizing Radiation (RPS 14, section 3.1.8) 5 to periodically compare patient doses with established DRLs. Imaging facilities enter technique, patient and radiation dose data for routine imaging protocols and receive a report comparing that dose data to the current national DRLs.…”

Section: Introductionmentioning

confidence: 99%