Establishment of diagnostic reference levels in cardiac computed tomography

Area of Science:

• Radiology
• Medical Physics
• Public Health

Background:

• Cardiac computed tomography (CCT) is a vital diagnostic tool.
• Establishing radiation dose benchmarks is crucial for patient safety and effective healthcare.
• Previous DRLs for CCT are not specific to the Jordanian population or healthcare system.

Purpose of the Study:

• To determine diagnostic reference levels (DRLs) for cardiac computed tomography (CCT) in Jordan.
• To assess radiation dose variations across different healthcare facilities.
• To identify areas for potential dose optimization in CCT examinations.

Main Methods:

• Collected volume computed tomography dose index (CTDIvol) and dose-length product (DLP) data from 228 CCT scans across seven Jordanian hospitals.
• Defined DRLs based on the 75th percentile of CTDIvol and DLP.
• Analyzed dose variations in relation to acquisition parameters like mAs and kVp.

Main Results:

• The proposed DRLs for CCT (mixed retrospective and prospective gated modes) are 47.74 mGy for CTDIvol and 1035 mGy/cm for DLP.
• A significant 5.1-fold variation in median DLP was observed among hospitals (range: 223.2–1146.7 mGy/cm).
• Dose variations were linked to differences in acquisition protocols, specifically mAs and kVp settings.

Conclusions:

• This study establishes the first DRLs for CCT in Jordan.
• Wide variability in radiation doses necessitates dose optimization strategies for CCT in Jordan.
• Implementing standardized protocols can reduce unnecessary radiation exposure for patients undergoing CCT.