Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study

Brat, Hugues; Zanca, Federica; Montandon, Stéphane; Racine, Damien; Rizk, Benoît; Eric, Meicher; Fournier, Dominique

doi:10.1007/s00330-019-06257-x

Cited by 31 publications

(23 citation statements)

References 24 publications

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“…Each hospital was given 16 weeks to complete the survey. The number of cases for each procedure in previous studies and recommendation varied from 10 to 20 patients [8,9]. In this study and for better typical practice, 20 patients from each procedure were selected.…”

Section: Survey Design and Data Collectionmentioning

confidence: 99%

“…Although the UAE is a part of the Asian countries, it is ranked fifth in global obesity. This fact in addition to the used protocol can explain the higher CTDI value, and in the future study and with the protocol optimization and clinical indication DRL establishment, patient weight will be better controlled [7,8]. Table 2 shows the examination protocols in the surveyed hospitals.…”

Section: Patients' Characteristicsmentioning

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%

Section: Patients' Characteristicsmentioning

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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“…DRLs are often not related to precise clinical indication, nor to any clinical image quality criteria. The first limitation was partially addressed by recently published national or local DRLs [4][5][6][7][8][9], and at the European level [10]; the second one is still an open question as mentioned by Rehani [11]. Moreover, the technological differences between CT scanners should be taken into account when dealing with clinical protocol optimization.…”

Section: Introductionmentioning

confidence: 99%

Assessment of task-based image quality for abdominal CT protocols linked with national diagnostic reference levels

et al. 2021

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Objectives To assess task-based image quality for two abdominal protocols on various CT scanners. To establish a relationship between diagnostic reference levels (DRLs) and task-based image quality. Methods A protocol for the detection of focal liver lesions was used to scan an anthropomorphic abdominal phantom containing 8- and 5-mm low-contrast (20 HU) spheres at five CTDIvol levels (4, 8, 12, 16, and 20 mGy) on 12 CTs. Another phantom with high-contrast calcium targets (200 HU) was scanned at 2, 4, 6, 10, and 15 mGy using a renal stones protocol on the same CTs. To assess the detectability, a channelized Hotelling observer was used for low-contrast targets and a non-prewhitening observer with an eye filter was used for high contrast targets. The area under the ROC curve and signal to noise ratio were used as figures of merit. Results For the detection of 8-mm spheres, the image quality reached a high level (mean AUC over all CTs higher than 0.95) at 11 mGy. For the detection of 5-mm spheres, the AUC never reached a high level of image quality. Variability between CTs was found, especially at low dose levels. For the search of renal stones, the AUC was nearly maximal even for the lowest dose level. Conclusions Comparable task-based image quality cannot be reached at the same dose level on all CT scanners. This variability implies the need for scanner-specific dose optimization. Key Points • There is an image quality variability for subtle low-contrast lesion detection in the clinically used dose range. • Diagnostic reference levels were linked with task-based image quality metrics. • There is a need for specific dose optimization for each CT scanner and clinical protocol.

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“…Each of these CIs require quite different CT protocols to answer the clinical question with quite different patient radiation exposure. The last few years, the term clinical DRLs is introduced with limited number of studies defining DLRs in terms of CI [ [11] , [12] , [13] , [14] ]. Also, recently a European Project was funded by the European Commission with the aim to define DRLs for the most important clinical indications across Europe [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Towards establishment of diagnostic reference levels based on clinical indication in the state of Qatar

AlNaemi

Tsapaki

Omar

et al. 2020

European Journal of Radiology Open

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Highlights This is the first study in the Asian region and one of the very few that established DRLs based on clinical indication for CT. Standardized CI nomenclature must be established as there are no guidelines for accurate comparison between studies on CT patient exposure. The established clinical DRL values for CT will further facilitate patient dose optimization and quality improvement process HMC in Qatar.

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Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study

Cited by 31 publications

References 24 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

Assessment of task-based image quality for abdominal CT protocols linked with national diagnostic reference levels

Towards establishment of diagnostic reference levels based on clinical indication in the state of Qatar

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