An audit of published South African diagnostic reference level data

Area of Science:

• Medical Physics
• Radiology
• Radiation Protection

Background:

• Diagnostic reference levels (DRLs) are crucial for optimizing patient radiation dose in X-ray imaging.
• South African legislation mandates DRLs for 26 fluoroscopically guided procedures (FGPs).

Purpose of the Study:

• To comprehensively review and collate all published South African data on DRLs.
• To prepare for the establishment of national DRLs in South Africa.
• To identify gaps and areas for improvement in DRL data collection and reporting.

Main Methods:

• Systematic searches of applicable databases were conducted.
• Inclusion criteria focused on research proposing DRLs for any imaging procedure in South Africa.
• Twenty-one relevant publications from 2001 onwards were identified.

Main Results:

• Two-thirds of studies reported on FGPs; five on computed tomography (CT).
• Three publications focused on pediatric imaging DRLs; none on mammography or dental radiography.
• Proposed DRLs for procedures varied up to fivefold, with endovascular aneurysm repair showing the highest proposed DRL (373.1 Gy cm²).

Conclusions:

• This review is the first comprehensive collation of SA DRL data, advancing international radiation protection.
• Significant room exists for interdisciplinary collaboration and rigorous standardization of parameters and data collection.
• Standardized terminology, especially for FGPs, is essential for future DRL audits and national DRL establishment.