Reference Levels for Diagnostic and Interventional X-ray Exposures in Germany: Development, Handling, and Perspective

Area of Science:

• Medical Physics
• Radiology
• Radiation Protection

Background:

• Diagnostic and interventional X-ray applications constitute over 95% of man-made radiation exposure in Germany.
• National Diagnostic Reference Levels (DRLs) are crucial for optimizing these procedures and ensuring patient safety.
• Regular adjustments to DRLs are necessary to incorporate advancements in device technology and clinical practices.

Purpose of the Study:

• To present the fundamental concept of Diagnostic Reference Levels (DRLs).
• To detail the methodological development and evolution of DRLs in Germany.
• To highlight the improvements in patient protection resulting from the implementation of DRLs.

Main Methods:

• Summarizing relevant regulations within Germany's new radiation protection legislation.
• Describing the historical development of DRLs in Germany from 2003 to 2022.
• Providing guidance for the practical application of DRLs and facility-specific measures.

Main Results:

• DRLs in Germany have been substantially reduced over nearly two decades.
• Continuous protocol optimization and advanced hardware/software have led to significant dose reductions.
• The scope of X-ray examinations covered by DRLs has expanded, with some obsolete DRLs removed.

Conclusions:

• The consistent implementation of the DRL concept is effective in practice, leading to substantial reductions in patient exposure.
• The positive impact on patient protection justifies the effort and potential investment in updating technology.
• Continuous development of the DRL concept is essential for ongoing optimization of radiation protection.