Establishing diagnostic reference levels for CT examinations in the south region of Saudi Arabia

Abstract

This study aims to establish local diagnostic reference levels (DRLs) for the most common computed tomography (CT) examinations in the southern region of Saudi Arabia. Data has been collected from 399 adult patients (234 males and 165 females) and 76 paediatric patients (51 males and 25 females) undergoing different CT procedures. These procedures are as follows: CT chest (adults: 107, paediatrics: 10), abdomen (adults: 121, paediatrics: 11), pelvis (adults: 74), brain (adults: 48, paediatrics: 55), abdominopelvic (AP) (adults: 17), liver Tri-phase (adults: 12), and chest abdomen pelvis (CAP) CT scan (adults: 20). For adult patients, the CTDIvol for chest, abdomen, pelvis, brain, AP, CAP, and liver tri-phase procedures ranged from 3.74 to 22.61 mGy, 2.52–51.40 mGy, 9.53–38.63 mGy, 5.72–5109.0 mGy, 2.54–17.16 mGy, 3.93–29.14 mGy, and 12.35–40.55 mGy, respectively. Similarly, CTDIvol for chest, abdomen, and brain paediatric procedures ranged from 3.15 to 5.25 mGy, 3.23–224.32 mGy, and 16.47–109.08 mGy, respectively. For adult patients, the study observed that dose length product for chest, abdomen, pelvis, brain, AP, CAP, and liver tri-phase procedures ranged from 136.50 to 1124.13 mGy cm, 137.70–1403.66 mGy cm, 244.14–1205.30 mGy cm, 98.20–1163.0 mGy cm, 6.43–893.60 mGy cm, 284.10–2216.70 mGy cm, and 415.20–2055.90 mGy cm, respectively. Similarly, dose length product for chest, abdomen, and brain paediatrics procedures ranged from 122.81 to 175.34 mGy cm, 5.34–553.51 mGy cm, and 333.60–2084.0 mGy cm, respectively. Radiation doses varied between hospitals, with wide variation in technical settings suggesting an urgent need for establishing a national DRL as a necessary part for dose optimisation.