National diagnostic reference levels: What they are, why we need them and what’s next

Abstract

Diagnostic reference levels (DRLs) are an optimisation tool for medical imaging procedures using ionising radiation. They give an indication of the expected radiation dose received by an average-sized patient undergoing a given imaging procedure. Comparison of typical (median) exposure levels for common imaging procedures with DRLs helps imaging facilities identify procedures that may be amenable to further optimisation. Undertaking comparisons with published DRLs is a requirement for medical imaging facilities under the Code for Radiation Protection in Medical Exposure and for their access to Medicare rebates under the Diagnostic Imaging Accreditation Scheme (DIAS). The Australian Radiation Protection and Nuclear Safety Agency has created the National Diagnostic Reference Level Service to facilitate the collection of data for the establishment of national DRLs in Australia and to assist imaging facilities in comparing their typical doses with the national DRLs. National DRLs have been established in computed tomography, nuclear medicine, and for image-guided and interventional procedures. DRLs must be subject to ongoing review and revision by the national authority to ensure they reflect current practice. This ongoing cycle of assessment and review helps to ensure that the ratio of benefit to risk for patients is maximised.

Patient Dose Estimation in Computed Tomography-Guided Biopsy Procedures

“…However, it is essential to recognize that there remain several avenues for further research to comprehensively explore and understand the intricate dynamics of radiation dose optimization in clinical practice. Future studies should delve into the influence of multiple factors on the total DLP, including the number of treatment targets, the specific organ being treated (e.g., hepatic tumor versus renal tumor), diverse anatomical positions within the same procedure (e.g., cervical, thoracic, or lumbar for vertebroplasty), variations in tumor destruction techniques (such as radiofrequency, microwave, or cryotherapy), and the integration of complementary imaging systems alongside CT [25][26][27][28][29][30].…”

Radiation Exposure Assessment in Coronary Angiography CT Scan: Establishing Diagnostic Reference Level for Northeast Assam Population

“…Even though using phantom produces almost identical exposures, it only addresses elements under our control [28]. DRLs are recommended levels of radiation exposure for typical patients undergoing a specific type of imaging procedure [29]. They are meant to be a benchmark to optimize imaging protocols and reduce unnecessary radiation exposure while maintaining image quality [30].…”

Radiation exposure assessment in coronary angiography computed tomography scan: Establishing diagnostic reference level for northeast Assam population

“…28 DRLs are recommended levels of radiation exposure for typical patients undergoing a specific type of imaging procedure. 29 They are meant to be a benchmark to optimise imaging protocols and reduce unnecessary radiation exposure while maintaining image quality. 30 It should be emphasised that these values do not represent absolute limits and certain patients may require higher doses for diagnostic purposes based on factors such as their age, body size and the specific medical condition being examined.…”