Proposing computed tomography diagnostic reference levels in Jordan: a national multicentre analysis.

Area of Science:

• Radiology and Medical Imaging
• Radiation Protection
• Health Policy

Background:

• Increasing CT utilization raises concerns about patient radiation exposure.
• Diagnostic Reference Levels (DRLs) are essential for optimizing radiation dose while maintaining image quality.
• Jordan lacks national DRLs, potentially leading to significant dose variability across healthcare facilities.

Purpose of the Study:

• To establish the first national Diagnostic Reference Levels (DRLs) for common CT examinations in Jordan.
• To assess current radiation dose levels and identify factors contributing to dose variability in Jordanian hospitals.
• To provide benchmarks for optimizing radiation dose and improving quality in CT imaging.

Main Methods:

• A multicentre retrospective study involving 4310 adult patients across 10 Jordanian hospitals.
• Collection of radiation dose metrics (CTDIvol and DLP) from PACS and RIS.
• Derivation of proposed national DRLs using the 75th percentile of median dose values and regression analysis to identify dose predictors.

Main Results:

• Significant variations in CT radiation doses were observed among participating hospitals.
• Head CT scans showed the highest median doses (CTDIvol: 65 mGy, DLP: 1572 mGy·cm), while high-resolution chest CT had the lowest.
• The product of mAs was the primary predictor of dose; Jordanian CT doses were generally comparable to international DRLs, with L-spine CT being an exception.

Conclusions:

• The study successfully proposed the first national DRLs for 14 common CT examinations in Jordan.
• These DRLs serve as crucial benchmarks for dose optimization, standardization of protocols, and emphasize the need for ongoing radiographer training.
• Future efforts should focus on extending DRL development to pediatric CT and integrating dose monitoring into national quality frameworks.