A process description to establish clinical indicated diagnostic reference level values for abdominal computed...

Area of Science:

• Radiological Physics
• Medical Imaging
• Radiation Protection

Background:

• Diagnostic reference levels (DRL) are crucial for optimizing radiation dose in medical imaging.
• The International Commission on Radiological Protection (ICRP) recommends establishing clinical indicated diagnostic reference levels (ciDRL) for ionizing radiation modalities.
• ciDRL, based on clinical indication, offers a more reliable dose assessment than anatomical DRLs.

Purpose of the Study:

• To present practical guidelines for establishing ciDRL values in computed tomography (CT) for adult chest-abdomen-pelvis (CAP) and abdomen-pelvis (AbP) examinations.
• To provide a framework for dose and image quality optimization (DIQO) teams in hospital settings.
• To assist researchers in determining ciDRL values, potentially incorporating size-specific dose estimates (SSDE).

Main Methods:

• Identify common clinical indications for specific anatomical regions (CAP and AbP).
• Collect data from at least 20 patients per clinical indication for CT examinations.
• Establish ciDRL values based on median (typical) or 75th percentile, adhering to ICRP guidelines.

Main Results:

• The proposed guidelines facilitate the establishment of ciDRL for CT CAP and AbP examinations.
• The methodology allows for the determination of reliable dose metrics tailored to specific clinical scenarios.
• Implementation of ciDRL can lead to more consistent and appropriate radiation dosing.

Conclusions:

• Establishing ciDRL values is essential for optimizing radiation dose in CT examinations.
• These guidelines provide a practical approach for hospitals and researchers to implement ciDRL.
• Adoption of ciDRL promotes radiation dose optimization and patient safety in medical imaging.