Establishment of local diagnostic reference levels for computed tomography with cloud-based automated dose-tracking...

Area of Science:

• Medical Imaging
• Radiology
• Radiation Protection

Background:

• Computed Tomography (CT) procedures require established diagnostic reference levels (DRLs) to ensure radiation safety and optimize patient doses.
• Automated dose-tracking software offers a scalable solution for collecting and analyzing large datasets necessary for DRL establishment.
• Variability in CT scanner protocols necessitates standardization to ensure consistent and safe radiation practices.

Purpose of the Study:

• To establish local diagnostic reference levels (LDRLs) for various computed tomography (CT) examinations in Turkey.
• To compare established LDRLs with national DRLs (NDRLs) and international DRLs to identify discrepancies.
• To assess inter-CT scanner variability to guide protocol standardization efforts.

Main Methods:

• Utilized cloud-based automated dose-tracking software to collect dose data from 104,272 adult CT examinations across 8 scanners over 12 months.
• Included protocols such as head CT, cervical spine CT, neck CT, chest CT, abdomen-pelvis CT, lumbar spine CT, HRCT, and coronary CTA.
• Determined LDRLs using the 75th percentile of median Volume CT Dose Index (CTDIvol) and Dose Length Product (DLP) values.

Main Results:

• Established LDRLs for eight common CT protocols, providing specific CTDIvol and DLP values for each.
• Found that the established LDRLs were comparable to or lower than existing NDRLs and international DRLs for most protocols.
• Identified significant inter-CT scanner variability in certain protocols, indicating a need for standardization and dose optimization.

Conclusions:

• The study underscores the necessity of updating the NDRLs for CT protocols in Turkey.
• Recommends that local institutions utilize the established LDRLs for immediate dose optimization and protocol comparison.
• Emphasizes the critical role of automated dose-tracking software in facilitating the establishment and maintenance of DRLs.