Australian diagnostic reference levels for multi detector computed tomography

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) is undertaking web based surveys to obtain data to establish national diagnostic reference levels (DRLs) for diagnostic imaging. The first set of DRLs to be established are for multi detector computed tomography (MDCT). The survey samples MDCT dosimetry metrics: dose length product (DLP, mGy.cm) and volume computed tomography dose index (CTDIvol, mGy), for six common protocols/habitus: Head, Neck, Chest, AbdoPelvis, ChestAbdoPelvis and Lumbar Spine from individual radiology clinics and platforms. A practice reference level (PRL) for a given platform and protocol is calculated from a compliant survey containing data collected from at least ten patients. The PRL is defined as the median of the DLP/CTDIvol values for a single compliant survey. Australian National DRLs are defined as the 75th percentile of the distribution of the PRLs for each protocol and age group. Australian National DRLs for adult MDCT have been determined in terms of DLP and CTDIvol. In terms of DLP the national DRLs are 1,000 mGy cm, 600 mGy cm, 450 mGy cm, 700 mGy cm, 1,200 mGy cm, and 900 mGy cm for the protocols Head, Neck, Chest, AbdoPelvis, ChestAbdoPelvis and Lumbar Spine respectively. Average dose values obtained from the European survey Dose Datamed I reveal Australian doses to be higher by comparison for four out of the six protocols. The survey is ongoing, allowing practices to optimise dose delivery as well as allowing the periodic update of DRLs to reflect changes in technology and technique.