Abstract
ObjectivesThe objectives of this study were to: 1) evaluate patient radiation exposure in CT and 2) establish CT Diagnostic Reference Levels (DRL)s based on clinical indication (CI) in Qatar. Materials and MethodsPatient data for 13 CIs were collected using specially designed collection forms from the dose management software (DMS) of Hamad Medical Corporation (HMC), the main Qatar healthcare provider. The methodology described in the International Commission on Radiological Protection (ICRP) Report 135 was followed to establish national clinical DRLs in terms of Volumetric Computed Tomography Dose Index (CTDIvol) and total Dose Length Product (DLPt). Effective dose (Ef) was estimated by DMS using DLPt and appropriate conversion factors and was analyzed for comparison purposes. ResultsData were retrospectively collected for 896 adult patients undergoing CT examinations in 4 hospitals and 7 CT scanners. CT for Diffuse infiltrative lung disease imparted the lowest radiation in terms of CTDIvol (5 mGy), DLPt (181 mGy.cm) and Ef (3.6 mSv). Total body CT for severe trauma imparted the highest DLPt (3137 mGy.cm) and Ef (38.6 mSv) of all CIs with a CTDIvol of 15 mGy. Rounded Third quartile CTDIvol and DLPt values were defined as the Qatar CT clinical DRLs. Comparison was limited due to sparse international literature. When this was possible data were lower or comparable with other studies. ConclusionsThis is the first study reporting national clinical DRLs in Asia and second one internationally after UK. For accurate comparison between studies, systemized CI nomenclature must be followed by researchers.
Highlights
Medical imaging is a important tool that helps the referring physician answer simple and multiple complex clinical questions that were not possible to answer previously
The methodology described in the International Commission on Radiological Protection (ICRP) Report 135 was followed to establish national clinical Diagnostic Reference Level (DRL) in terms of Volumetric Computed Tomography Dose Index (CTDIvol) and total Dose Length Product (DLPt)
There seems to be no specific trend on patient age and Clinical Indications (CIs) apart from the fact that for 8 out of 13 CIs, patients were under the age of 50 years and for 5 of them patients were in the range of 30–40 years
Summary
Medical imaging is a important tool that helps the referring physician answer simple and multiple complex clinical questions that were not possible to answer previously. The evolution of medical technology is facilitating this procedure. Evolution in computer power enabled rapid use and growth of iterative image reconstruction algorithms with enormous possibilities in radiation dose reduction [1]. All this evolution of CT technology has revolutionized the pathway of patient diagnosis and treatment but still comes at the expense of radiation exposure. The latest NCRP 184 report published in 2019, that updates medical radiation exposure information with data collected between 2006 and 2016, states that still today Computed To mography (CT) scanning is the largest contributor to collective effective dose [2]
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