Update of national diagnostic reference levels for adult CT in Switzerland and assessment of radiation dose reduction since 2010

Aberle, Christoph; Ryckx, Nick; Treier, Reto; Schindera, Sebastian T.

doi:10.1007/s00330-019-06485-1

Cited by 35 publications

(20 citation statements)

References 17 publications

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“…Staff training, together with the evaluation of local dose values and comparison with DRLs, were previously shown to be efficient in optimising dose in CT practice [41]. Moreover, CT hardware and software technology continues to advance steadily with the introduction of newer dose optimisation techniques [12]; hence, radiographers' knowledge needs to be updated frequently to be efficient in the discharge of their duties.…”

Section: Knowledge and Awareness About Drls As An Optimisation Toolmentioning

confidence: 99%

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Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers

Abdulkadir

Piersson

Musa

et al. 2021

Egypt J Radiol Nucl Med

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Background Reports indicated that numerous factors, including inadequate personnel knowledge, contributes to insufficient patient data for setting up diagnostic reference levels (DRLs) in developing countries. This study aims to evaluate the knowledge of DRLs as an optimisation tool amongst computed tomography (CT) radiographers in northern Nigeria. This is a quantitative cross-sectional study. A structured questionnaire was devised and distributed on site to sixty-two CT radiographers in northern Nigeria. A total of fifteen questions were included in the questionnaire focusing on DRLs, dose optimisation and dose descriptors generating quantitative data concerning overall CT radiographers’ perceived knowledge and awareness about DRLs. Results A response rate of 77.4% (48/62) was achieved. About 83.3% of the participants declare DRLs awareness, and 37.5% carried out a local dose survey. The percentage correctly perceived knowledge of concepts; DRLs was 45.8%, dose optimisation (42%) and CT dose descriptor (39%). Radiographers with work experience ranging from 4-10 years had the highest score. Conclusion In this survey, deficiencies were noted in radiographers’ knowledge about DRLs with precise knowledge gap in the implementation of local dose survey for DRLs and optimisation. There is a need for continuous radiographers’ training with greater emphasis on dose optimisation and institutional based dose evaluation.

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Section: Knowledge and Awareness About Drls As An Optimisation Toolmentioning

confidence: 99%

“…Periodic review of doses (DRLs) led to a substantial decline in dose levels as documented in national CT dose studies [9,12]. However, lack of sufficient patient dose data for setting up DRLs is related to lack of qualified personnel, tools, appropriate methodology and coordination at the national level.…”

Section: Introductionmentioning

confidence: 99%

Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers

Abdulkadir

Piersson

Musa

et al. 2021

Egypt J Radiol Nucl Med

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“…Five volume computed tomography dose index (CTDI vol ) levels were used for each set (4,8,12,16, and 20 mGy for focal liver lesions and 2, 4, 6, 10, and 15 mGy for renal stones). The current Swiss DRLs (11 mGy for focal liver lesions CT acquisitions and 6 mGy for renal stones CT acquisitions) and the underlying dose distributions [6] were used to determine the 5 CTDI vol levels, so that they cover the clinically relevant dose range.…”

Section: Ct Scanners and Acquisition/reconstruction Parametersmentioning

confidence: 99%

“…DRLs are often not related to precise clinical indication, nor to any clinical image quality criteria. The first limitation was partially addressed by recently published national or local DRLs [4][5][6][7][8][9], and at the European level [10]; the second one is still an open question as mentioned by Rehani [11]. Moreover, the technological differences between CT scanners should be taken into account when dealing with clinical protocol optimization.…”

Section: Introductionmentioning

confidence: 99%

Assessment of task-based image quality for abdominal CT protocols linked with national diagnostic reference levels

et al. 2021

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Objectives To assess task-based image quality for two abdominal protocols on various CT scanners. To establish a relationship between diagnostic reference levels (DRLs) and task-based image quality. Methods A protocol for the detection of focal liver lesions was used to scan an anthropomorphic abdominal phantom containing 8- and 5-mm low-contrast (20 HU) spheres at five CTDIvol levels (4, 8, 12, 16, and 20 mGy) on 12 CTs. Another phantom with high-contrast calcium targets (200 HU) was scanned at 2, 4, 6, 10, and 15 mGy using a renal stones protocol on the same CTs. To assess the detectability, a channelized Hotelling observer was used for low-contrast targets and a non-prewhitening observer with an eye filter was used for high contrast targets. The area under the ROC curve and signal to noise ratio were used as figures of merit. Results For the detection of 8-mm spheres, the image quality reached a high level (mean AUC over all CTs higher than 0.95) at 11 mGy. For the detection of 5-mm spheres, the AUC never reached a high level of image quality. Variability between CTs was found, especially at low dose levels. For the search of renal stones, the AUC was nearly maximal even for the lowest dose level. Conclusions Comparable task-based image quality cannot be reached at the same dose level on all CT scanners. This variability implies the need for scanner-specific dose optimization. Key Points • There is an image quality variability for subtle low-contrast lesion detection in the clinically used dose range. • Diagnostic reference levels were linked with task-based image quality metrics. • There is a need for specific dose optimization for each CT scanner and clinical protocol.

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“…At the Department of Radiology at the Medical University of Innsbruck, diagnostic reference levels were implemented for CT as recommended by European societies [19]. However, for the sole purpose of identifying minuscule temporal bone structures in the middle or inner ear, low-dose protocols may suffice when iterative reconstructive techniques (IRT) are applied to compensate for increases in image noise.…”

Section: Introductionmentioning

confidence: 99%

ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols

et al. 2021

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Objective: Repeated computed tomography (CT) is essential for diagnosis, surgical planning and follow-up in patients with middle and inner ear pathology. Dose reduction to “as low as diagnostically acceptable” (ALADA) is preferable but challenging. We aimed to compare the diagnostic quality of images of subtle temporal bone structures produced with low doses (LD) and reference protocols (RP). Methods: Two formalin-fixed human cadaver heads were scanned using a 64-slice CT scanner and cone-beam CT (CBCT). The protocols were: RP (120 kV, 250 mA, CTDIvol 83.72 mGy), LD1 (100 kV, 80 mA, CTDIvol 26.79 mGy), LD2 (100 kV, 35 mA, CTDIvol 7.66 mGy), LD3 (80 kV, 40 mA, CTDIvol 4.82 mGy), and CBCT standard protocol. Temporal bone structures were assessed using a 5-point scale. Results: A median score of ≥2 was achieved with protocols such as the tendons of m. tensor tympani (RP/LD1/LD2/CBCT) and m. stapedius (CBCT), the incudostapedial joint (RP/LD1/CBCT), the incudomalleolar joint (RP/LD1/LD2/CBCT), the stapes feet (RP/LD1/CBCT), the stapes head (RP/LD1/LD2/CBCT), the tympanic membrane (RP/LD1/LD2/CBCT), the lamina spiralis ossea (none), the chorda tympani (RP/LD1/CBCT), and the modiolus (RP/LD1/LD2/CBCT). Adaptive statistical iterative reconstructions did not show advantages over the filtered back projection. Conclusions: LD protocols using a CTDIvol of 7.66 mGy may be sufficient for the identification of temporal bone structures.

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Update of national diagnostic reference levels for adult CT in Switzerland and assessment of radiation dose reduction since 2010

Cited by 35 publications

References 17 publications

Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers

Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers

Assessment of task-based image quality for abdominal CT protocols linked with national diagnostic reference levels

ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols

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