A literature review of paediatric Diagnostic Reference Levels in Diagnostic and Interventional Radiology and Cardiology

Abstract

The use of Diagnostic Reference Levels (DRLs) in Radiology is imposed by the European Directive 2013/59. It is an important tool especially for the optimisation of children exposure. During the last years, guidelines regarding the establishment of DRLs have been proposed in European and International level. This manuscript is a literature review of the available national or local paediatric DRLs in diagnostic and Interventional Radiology and Cardiology. Most of the existing studies have been performed before the guidelines. Therefore, there is no common methodology between studies for the DRL calculation. This fact, in conjunction with the difficulty of obtaining a large sample of paediatric patients, has as consequence the report of non-comparable DRLs. The most recent studies seem to follow the guidelines; however further similar studies need to be realised for the establishment and renewal of paediatric DRLs by following the recommendations, e.g. weight grouping for body examinations and age grouping for head examinations. DRLs as a function of body weight are an interesting solution in case of small samples. The new approach of setting DRLs based on clinical indication should be carefully considered. A strong collaboration of all healthcare professionals is important for the establishment of reliable DRLs.