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National indication-based diagnostic reference level values in computed tomography: Preliminary results from Ghana
Benard Ohene Botwe1, Cyril Schandorf2, Stephen Inkoom3
1Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana; Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Legon, Ghana.
This study established national diagnostic reference levels (DRLs) for adult computed tomography (CT) scans in Ghana. These DRLs will help manage CT radiation dose effectively for common medical indications.
Area of Science:
- Radiological Sciences
- Medical Imaging
- Radiation Protection
Background:
- Diagnostic Reference Levels (DRLs) are crucial for optimizing radiation dose in medical imaging.
- Establishing national DRLs ensures consistency and safety in computed tomography (CT) examinations.
- Ghana lacked specific national DRLs for common adult CT indications prior to this study.
Purpose of the Study:
- To develop national indication-based Diagnostic Reference Levels (DRLs) for adult computed tomography (CT) examinations in Ghana.
- To provide clinical guidance for managing CT radiation dose.
- To facilitate the adoption of standardized radiation protection practices in Ghanaian radiology departments.
Main Methods:
- Employed the International Commission on Radiological Protection (ICRP) Publication 135 methodology for DRL development.
- Collected CT dose data (CTDIvol and DLP) from 25 CT scanners across Ghana, representing 71.4% of the national CT infrastructure.
- Assessed objective image quality using signal-to-noise ratio (SNR) analysis before data extraction.
Main Results:
- Established national DRL values for common CT indications including cerebrovascular accident/stroke, head trauma, brain tumors, lung tumors, chest lesions with CKD, abdominopelvic lesions, kidney stones, urothelial malignancy, and pulmonary embolism.
- Reported DRLs in terms of volume weighted CT dose index (CTDIvol) and dose length product (DLP) for each indication.
- Data sets were collected from 3960 examinations accepted by radiologists.
Conclusions:
- The developed national indication-based DRL values are recommended for managing CT radiation dose in Ghana.
- Implementation of these DRLs can lead to optimized patient radiation exposure.
- This study provides a foundation for ongoing quality assurance in CT imaging within Ghana.