Establishment of CT diagnostic reference levels in Ireland

Abstract

To propose Irish CT diagnostic reference levels (DRLs) by collecting radiation doses for the most commonly performed CT examinations. A pilot study investigated the most frequent CT examinations. 40 CT sites were then asked to complete a survey booklet to allow the recording of CT parameters for each of 9 CT examinations during a 12-week period. Dose data [CT volume index (CTDI(vol)) and dose-length product (DLP)] on a minimum of 10 average-sized patients in each category were recorded to calculate a mean site CTDI(vol) and DLP value. The rounded 75th percentile was used to calculate a DRL for each site and the country by compiling all results. are compared with international DRL data. Results Data were collected for 3305 patients. 30 sites responded with data for 34 scanners, representing 54% of the national total. All equipment had multislice capability (2-128 slices). DRLs are proposed using CTDI(vol) (mGy) and DLP (mGy cm) for CT head (66/58 and 940, respectively), sinuses (16 and 210, respectively), cervical spine (19 and 420, respectively), thorax (9/11 and 390, respectively), high resolution CT (7 and 280, respectively), CT pulmonary angiography (13 and 430, respectively), multiphase abdomen (13 and 1120, respectively), routine abdomen/pelvis (12 and 600, respectively) and trunk examinations (10/12 and 850, respectively). These values are lower than current DRLs and comparable to other international studies. Wide variations in mean doses are noted across sites. Baseline figures for Irish CT DRLs are provided on the most frequently performed CT examinations. The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimisation of examinations.