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Niveles de referencia diagnósticos basados en la indicación clínica en TC: una revisión sistemática

Abdul Alim1,2, Sook Sam Leong3,4, Ann Erynna Lema Thomas Sudin1

  • 1Center for Medical Imaging Studies, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia.

BMJ open
|February 4, 2026
PubMed
Resumen

Los niveles nacionales de referencia diagnóstica basados en indicaciones clínicas (NDRLci) en TC varían ampliamente. La estandarización del desarrollo de NDRLci es crucial para mejorar la comparabilidad de la dosis de TC a nivel mundial.

Palabras clave:
Tomografía computarizadaDiagnóstico por imagenRADIOLOGÍA Y DIAGNÓSTICO POR IMAGEN

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Área de la Ciencia:

  • Física radiológica e imagen médica; Diagnóstico por imagen y protección contra la radiación

Sus antecedentes:

  • Los niveles nacionales de referencia diagnóstica basados en indicaciones clínicas (NDRLci) se adoptan cada vez más a nivel mundial siguiendo las recomendaciones de la ICRP de 2017.; Existen variaciones significativas en las prácticas de NDRLci, lo que requiere un análisis comparativo y la identificación de los factores de influencia.

Objetivo del estudio:

  • Comparar las prácticas internacionales de NDRLci para exámenes de TC.; Identificar los factores que influyen en los valores de NDRLci en diferentes indicaciones clínicas.; Proponer recomendaciones basadas en evidencia para el desarrollo de NDRLci estandarizados.

Principales métodos:

  • Revisión sistemática de la literatura de estudios publicados entre 1996 y 2025.; Búsquedas realizadas en PubMed, Web of Science y Scopus.; Adhesión a las directrices PRISMA y evaluación crítica utilizando las herramientas del Joanna Briggs Institute.

Principales resultados:

  • Se incluyeron once estudios, que analizaron 25 indicaciones clínicas en siete regiones anatómicas.; El NDRLci (DLP) más alto reportado para TC de cuerpo total en trauma severo (3830 mGy cm), el más bajo para sinusitis (70 mGy cm).; Se observaron discrepancias significativas en la dosis para las mismas indicaciones clínicas.

Conclusiones:

  • Factores como la tecnología de TC, los parámetros del protocolo y las características del paciente influyen en el NDRLci.; Son esenciales protocolos de TC estandarizados y optimizados.; La estandarización internacional del desarrollo de NDRLci es fundamental para la comparabilidad global.