Development of acceptable quality radiation dose levels for common computed tomography examinations: A focused multicenter study in United Arab Emirates

Abstract

PurposeDiagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen).MethodsThis study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, <50, 50–59, 60–69, 70–79, 80–89, 90–99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination.ResultsOut of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented.ConclusionImages with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.

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“…Most of the DRL's available data is based on anatomical region ( Abuzaid et al, 2020 ; Vassileva and Rehani, 2015 ). However, recent studies have highlighted the importance of establishing DRLs based on clinical indications due to using different protocols for the same anatomical area ( Elshami et al, 2022 ). For example, CT thorax protocol differs according to clinical indications such as P.E., cancer, and calcium scoring, which vary in scan parameters, contrast usage, number of series, and scan length.…”