Diagnostic Reference Levels From the ACR CT Accreditation Program

Cloud-Based CT Dose Monitoring using the DICOM-Structured Report: Fully Automated Analysis in Regard to National Diagnostic Reference Levels

“…The difference in radiation exposure in this study is in accordance with previous studies, which reported a significant reduction of radiation exposure in CT due to the use of iterative reconstruction instead of filtered back projection [10,11]. National DRLs for CT examinations have been reported for many countries, e. g. for Ireland [2], Germany [4], the United Kingdom [12], Canada [1], Portugal [13], Switzerland [14] and the US [15]. Mostly these DRLs are defined for examinations of a certain body region, while only very few DRLs are given for specific CT protocols [1].…”

Role of Reference Levels in Nuclear Medicine: A Report of the SNMMI Dose Optimization Task Force

“…For x-ray-based imaging modalities, reference levels are based on accepted measures of dose indices from each modality. For example, in CT, reference levels are based on the absorbed dose to a standard phantom (13). These absorbed dose indices are directly proportional to image quality-specifically, to the photon density in the images.…”

“…With increased awareness of the potential risks from ionizing radiation, numerous recent publications have been addressing and suggesting reference levels. These publications offer some differing definitions of reference levels and raise some philosophic questions about their origin, purpose, and appropriate use (9)(10)(11)(12)(13)(14). In this article, we discuss some considerations for application of reference levels to nuclear medicine in response to the ICRP Committee 3 recommendations encouraging "authorized bodies to set diagnostic reference levels that best meet their specific needs and that are consistent for the regional, national, or local area to which they apply" (7).…”

Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance

“…21 While they reported a CTDI vol of 47.8 mGy in their low-dose CT protocol, 21 similar to the dose in our clinical standard LDCT, our ULDCT had a mean CTDI vol of 15.55 mGy, representing a 67% reduction in comparison, and it was 79% lower than the 75-mGy limit recommended by the American College of Radiology guidelines. 22 An optimal CT protocol uses the lowest dose and provides the appropriate image quality for the clinical circumstances for which it is intended. Head CT is a critical tool for the surveillance of the NICU population, typically used serially to monitor and guide treatment.…”

“…In this study, we evaluated radiation dose and image quality of head CTs obtained with a NICUdesignated ultra-low-dose (ULDCT) protocol (120 dose-modulated effective milliampere-second), with a dose index volume (CTDI vol ) approximately 80% below the recommended reference level in the current American College of Radiology guidelines. 22 We compared these studies with our standard-of-care low-dose (LDCT) IR protocol (290 dose-modulated effective mAs), also SAFIRE-based, and with our legacy standard-dose (SDCT) FBP protocol (350 fixed milliampere-second). To our knowledge, the use of SAFIRE to support ultra-low-dose head CT for the repeated, approximately daily surveillance examinations in the vulnerable NICU population has not been reported.…”