3027 - Systematic Review on Adult Diagnostic Reference Levels in Computed Tomography, and Analysis of Regional Variability

05:00pm - 06:00pm PT

Hall F

Screen: 19

POSTER

Presenter(s)

Abdel-Baset Bani Yaseen, PhD, PhD candidate - Queensland University of Technology, Brisbane, Queensland

A. B. Bani Yaseen^1,2, J. Trapp^3,4, and D. Fontanarosa^1,3; ¹School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Gardens Point Campus, Brisbane, QLD 4000, Australia., Brisbane, QLD, Australia, ²Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan., Zarqaa, Zarqaa, Jordan, ³Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD 4000, Australia., Brisbane, QLD, Australia, ⁴School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Gardens Point Campus, Brisbane, QLD 4000, Australia., Brisbane, QLD, Australia

Purpose/Objective(s): Computed tomography (CT) is a crucial tool in medical imaging diagnostics, providing detailed internal imaging but exposing patients to ionizing radiation, which carries potential health risks. To optimize patient safety, the International Commission on Radiological Protection (ICRP) introduced diagnostic reference levels (DRLs) as benchmarks for acceptable radiation doses. This review critically evaluates the methodologies used to establish DRLs, examining how these benchmarks balance the imperative of minimizing radiation exposure while maintaining diagnostic accuracy. Additionally, it addresses the existing gap in the application and standardization of DRLs for adults. We hypothesize that the high regional variability in DRLs for CT examinations is primarily influenced by differences in imaging practices, patient demographics, and the availability of imaging technology. Understanding these factors is essential for harmonizing DRL implementation and enhancing radiation protection strategies.

Materials/Methods: A systematic literature search following PRISMA-S guidelines was conducted in PubMed, Web of Science, Scopus, and Embase for studies published in English between 2018 and 2024. Keywords related to DRLs and CT imaging were used. Inclusion criteria required explicit reporting of DRLs for adult CT using standardized dose metrics. Pediatric studies, case reports, narrative reviews, phantom studies, pilot studies, and grey literature were excluded.

Results: Of the 2719 articles retrieved, 62 were included, covering a wide range of adult DRLs in CT across regions. About 48% of the studies addressed local DRLs, and 52% focused on national benchmarks. Significant variability in DRL values was noted. For head CT scans, CT Dose Index (CTDI_vol) ranged from 65 mGy in Indonesia to 47 mGy in Singapore, with Dose-Length Product (DLP) values from 1400 mGy·cm to 820 mGy·cm. Abdomen and pelvis CTDI_vol ranged from 17 mGy to over 25 mGy in Europe, with inter-regional differences exceeding 30%, influenced by patient size, CT equipment, and protocols.

Conclusion: This systematic review reveals the global variability in DRLs, influenced by regional factors such as imaging practices, patient demographics, and available technology. Despite these differences, the findings affirm the importance of DRLs as a powerful tool for improving patient safety and promoting best practices worldwide. The review highlights the necessity of considering local healthcare contexts when implementing DRLs while aligning with international safety standards to ensure effective and judicious radiation use.