Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt

Salama, Dina H.; Vassileva, J.; Mahdaly, Gamal; Shawki, M.; Salama, Ahmad; Gilley, Deidre; Rehani, Madan M.

doi:10.1016/j.ejmp.2017.05.050

Cited by 71 publications

(49 citation statements)

References 12 publications

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“…The survey used previously (2017) in a CT dose survey performed in Egypt in collaboration with IAEA, which was kindly shared by the author. The data collected comprise scanner information, routine CT protocols, patient weight, examination data, and dose indices (CTDI and DLP) [3].…”

Section: Survey Design and Data Collectionmentioning

confidence: 99%

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Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates

et al. 2020

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Objectives: Computed tomography (CT) scanning is an essential part of diagnostic and treatment plans, providing swift and accurate diagnostic images. The aim of this study is to develop diagnostic reference levels (DRLs) for the adult common CT examination in the United Arab Emirates (UAE). Methods: This study presents results of the survey of CT dose indices. The data were collected from 91% of the scanners registered at the Ministry of Health and Prevention (MOHAP) for five common examinations: head, chest, and abdomen-pelvis with and without CM. Results: CT dose index, dose-length product, and patient weight were analyzed; the reference dose was calculated on the 75th percentile, and an achievable dose was proposed from the median value. The results were compared with the UAE initial National Dose Report as well as the international reports. The proposed dose for CTDI vol (mGy) and DLP (mGy cm) is as follows: head without CM 40 and 695, head with CM 48 and 820, chest 10 and 275, abdomen-pelvis without CM 14 and 810, and abdomen-pelvis with CM 20 and 1025. Conclusions: The results show low dose variations between the MOHAP scanners. The data also revealed CTDI vol and DLP values comparable to those in the initial NDRL report and international standards. The establishment of diagnostic reference levels will require a continuous dose monitoring system.

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Section: Survey Design and Data Collectionmentioning

confidence: 99%

“…DRLs are a tool used to identify situations in which radiation dosage is unusually elevated [2]. The establishment of DRLs is considered the initial step in the radiation dose monitoring process [3].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates

et al. 2020

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“…Hence, the risk of CT radiation exposure in children should be justified and optimized according to the "As Low As Reasonably Achievable" (ALARA) principle. However, several studies have found large differences in radiographic imaging procedures at different hospitals, prominent to varying degrees of radiation exposure on patients [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Generally, the DRL has been proposed as the 75th percentile (third quartile) of the national dose apportioning ever since it was first established by the ICRP in 1996. Noting that, professionals or regulatory bodies may determine a national DRL from wide-ranging surveys at hospitals in a region or country [6,7].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

et al. 2020

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Pediatrics are more vulnerable to radiation and are prone to dose compared to adults, requiring more attention to computed tomography (CT) optimization. Hence, diagnostic reference levels (DRLs) have been implemented as part of optimization process in order to monitor CT dose and diagnostic quality. The noise index has recently been endorsed to be included as a part of CT optimization in the DRLs report. In this study, we have therefore set local DRLs for pediatric CT examination with a noise index as an indicator of image quality. One thousand one hundred and ninety-two (1192) paediatric patients undergoing CT brain, CT thorax and CT chest-abdomen-pelvis (CAP) examinations were analyzed retrospectively and categorized into four age groups; group 1 (0–1 year), group 2 (1–5 years), group 3 (5–10 years) and group 4 (10–15 years). For each group, data such as the volume-weighted CT dose index (CTDIvol), dose-length product (DLP) and the effective dose (E) were calculated and DRLs for each age group set at 50th percentile were determined. Both CT dose and image noise values between age groups have differed significantly with p-value < 0.05. The highest CTDIvol and DLP values in all age groups with the lowest noise index value reported in the 10–15 age group were found in CT brain examination. In conclusion, there was a significant variation in doses and noise intensity among children of different ages, and the need to change specific parameters to fit the clinical requirement.

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“…Based on the findings on dose measurement and image quality metric quantification capability, the use of the in-house phantom in assessing CT system performance can be suggested for routine use by clinical medical physicists. The designed phantom's capability to serve as dose measurement tool allows routine application for dose survey in the clinical setting [16], establishment of diagnostic reference levels [17], and dose comparison upon introduction of new techniques or technology [18]. Contrast and CT number linearity reproducibility also indicated that the in-house phantom can also be useful for image quality quantification as well as dose management and optimization studies [19,20].…”

Section: Image Quality Metric Evaluationmentioning

confidence: 99%

Construction and Evaluation of a Multipurpose Performance Check Phantom for Computed Tomography

Lubis

Hariyati²,

Ryangga³

et al. 2020

Atom Indo.

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The use of computed tomography (CT) has become a common practice in medical diagnosis in Indonesia. Its number, however, is not matched by the availability of dedicated-performance-check phantoms. This paper aims to describe the design, construction, and evaluation of an in-house phantom for CT performance check that accommodates both radiation dose measurement and image quality performance checks. The phantom is designed as laser-cut polymethyl methacrylate (PMMA) slabs glued together to form a standard cylindrical shape, with spaces to place dose measurement and image quality modules. In this paper, measurement results on both aspects are discussed and compared with standard phantoms and other works. For dose measurement, the constructed phantom exhibited the greatest absolute discrepancy against the reference standard phantom of 8.89 %. Measurement of the CT number linearity and modulation transfer function (MTF) yielded, at most, 7.51 % and 5.07 % discrepancies against Catphan 604, respectively. Meanwhile, although found to be more linear in the phantom-based contrast linearity test, the use of the in-house phantom for clinical image contrast threshold determination requires further study. For noise power spectrum (NPS) measurement, accurate results were obtained within a limited range of spatial frequency.

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Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt

Cited by 71 publications

References 12 publications

Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates

Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

Construction and Evaluation of a Multipurpose Performance Check Phantom for Computed Tomography

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