Typical and Local Diagnostic Reference Levels for Chest and Abdomen Radiography Examinations in Dubai Health Sector

Chest and abdomen radiographs are the most common radiograph examinations conducted in the Dubai Health sector, with both involving exposure to several radiosensitive organs. Diagnostic reference levels (DRLs) are accepted as an effective safety, optimization, and auditing tool in clinical practice. The present work aims to establish a comprehensive projection and weight-based structured DRL system that allows one to confidently highlight healthcare centers in need of urgent action. The data of a total of 5474 adult males and non-pregnant females who underwent chest and abdomen radiography examinations in five different healthcare centers were collected and retrospectively analyzed. The typical DRL (TDRL) for each healthcare center was established and defined per projection (chest: posterior-anterior (PA), anterior-posterior (AP) and lateral (LAT); abdomen: erect and supine) for a weight band (60-80 kg) and for the whole data (no weight band). Local DRL (LDRL) values were established per project for the selected radiograph for the whole data (no weight band) and the 60-80 kg population. Chest radiography data from 1755 (60-80 kg) images were used to build this comprehensive DRL system (PA: 1471, AP: 252, and LAT: 32). Similarly, 611 (60-80 kg) abdomen radiographs were used to establish a DRL system (erect: 286 and supine: 325). The LDRL values defined per chest and abdomen projection for the weight band group (60-80 kg) were as follows: chest-0.51 PA, 2.46 AP, and 2.13 LAT dGy·cm²; abdomen-8.08 for erect and 5.95 for supine dGy·cm². The LDRL defined per abdomen projection for the 60-80 kg weight band highlighted at least one healthcare center in need of optimization. Such a system is efficient, easy to use, and very effective clinically.