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Investigating CT head diagnostic reference levels based on indication-based protocols - a single site study.

W S Tan1, S Foley1, M L Ryan1

  • 1Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.

Radiography (London, England : 1995)
|June 2, 2023
PubMed
Summary
This summary is machine-generated.

This study established computed tomography (CT) diagnostic reference levels (DRLs) for head examinations in Ireland, finding proposed DRLs significantly lower than national values. Radiation dose optimization for CT scans is crucial, with potential for gender-based DRLs requiring further investigation.

Keywords:
CT DRLsCT head examinationsClinical indicationsGender-based DRLsTypical value

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Area of Science:

  • Medical Imaging
  • Radiology
  • Radiation Protection

Background:

  • Computed tomography (CT) examinations are increasing globally, necessitating radiation dose optimization.
  • Diagnostic Reference Levels (DRLs) are essential for patient protection while maintaining image quality.
  • Indication-based protocols are vital for establishing relevant DRLs across diverse CT procedures.

Purpose of the Study:

  • To establish clinically relevant CT DRLs for indication-based protocols in Ireland.
  • To focus on CT head examinations conducted at a specialized neurology hospital.
  • To provide insights for optimizing radiation doses in CT procedures.

Main Methods:

  • Retrospective collection of dose data for six CT head indication-based protocols.
  • Establishment of typical values using the median of the distribution for a sample of 50 patients per protocol.
  • Non-parametric median test (k-samples) used to compare dose distributions and identify significant differences.

Main Results:

  • Significant differences in typical values were found between most protocol pairings (p < 0.001), except for specific stroke and brain indications.
  • The typical value for a 3-phase angiogram stroke protocol was 52% lower than for a standard stroke protocol.
  • Male patients exhibited higher radiation doses than female patients across all protocols, with significant gender-based differences in five protocols.

Conclusions:

  • Proposed typical values for Dose Length Product (DLP) were substantially lower (up to 63% and 69%) than existing EU and Irish national DRLs.
  • CT stroke DRLs should be based on the specific scan performed, not the number of acquisitions.
  • Further research into gender-based CT DRLs for head region protocols is warranted.