Local Diagnostic Reference Levels for X-Ray Examinations in an Australian Tertiary Hospital

Ng, Curtise; Sun, Zhonghua; Parry, Helen; Burrage, J.

doi:10.1166/jmihi.2014.1250

Cited by 2 publications

(5 citation statements)

References 14 publications

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“…For the lumbar spine AP, the IDRLs in this study were comparable to the median P KA reported in India, Oman, and Australia [30,32,33]. For the lumbar spine LAT, the IDRLs in this study were higher than the median in P KA reported in Oman (58.6%), Australia (30.4%), and Greece (10%) [29,32,33]. For the abdomen AP, the ADs and MCDRLs in this study were comparable to the ADs and NDRLs reported in the UK and Germany [34,35].…”

Section: This Studysupporting

confidence: 83%

“…For the KUB AP, the median P KA was only reported in Greece, and the present IDRLs were 20.8% higher than the median P KA reported [29]. For the lumbar spine AP, the IDRLs in this study were comparable to the median P KA reported in India, Oman, and Australia [30,32,33]. For the lumbar spine LAT, the IDRLs in this study were higher than the median in P KA reported in Oman (58.6%), Australia (30.4%), and Greece (10%) [29,32,33].…”

Section: This Studysupporting

confidence: 56%

“…India [30] Greece [29] Oman [33] Australia [32] Examination The percentage differences were calculated based on the minimum values of IDRL ranges in the present study and the median P KA in other studies. For the abdomen AP, the IDRLs in this study were higher than the median P KA reported in India (84.4%), Oman (84.4%), and Greece (21.4%) [29,30,33].…”

Section: This Studymentioning

confidence: 96%

“…Furthermore, in this study, most hospitals with CR systems consistently recorded higher patient doses than hospitals with DR systems for all four examinations. This is expected due to the wider dynamic range and higher detective quantum efficiency of flat-panel detectors in DR systems compared to CR phosphor plates [32].…”

Section: Patient Dose Indicatorsmentioning

confidence: 99%

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Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study

Welarathna,

Velautham,

Sarasanandarajah

2024

J. Radiol. Prot.

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Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient doses were measured in terms of kerma-area product (PKA) using a PKA meter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median PKA distributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm2 for abdomen AP, 1.51-2.86 Gy cm2 for KUB AP, 0.83-1.65 Gy cm2 for lumbar spine AP, and 1.76-4.10 Gy cm2 for lumbar spine LAT. The proposed ADs were 1.82 Gy cm2 (abdomen AP), 2.03 Gy cm2 (KUB AP), 1.27 Gy cm2 (lumbar spine AP), and 2.21 Gy cm2 (lumbar spine LAT). MCDRLs were 2.24 Gy cm2 (abdomen AP), 2.40 Gy cm2 (KUB AP), 1.43 Gy cm2 (lumbar spine AP), and 2.38 Gy cm2 (lumbar spine LAT). Substantial intra- and inter-hospital variations in PKA were observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.

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Section: This Studysupporting

confidence: 83%

Section: This Studysupporting

confidence: 56%

Section: This Studymentioning

confidence: 96%

Section: Patient Dose Indicatorsmentioning

confidence: 99%

See 2 more Smart Citations

Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study

Welarathna,

Velautham,

Sarasanandarajah

2024

J. Radiol. Prot.

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“…Hence, “as low as reasonably achievable” (ALARA) has become the fundamental principle of radiology practice [ 17 , 24 , 25 ]. International Commission on Radiological Protection (ICRP) has introduced the diagnostic reference levels (DRLs) initiative for radiological departments to identify examinations with radiation doses exceeding their corresponding DRLs and trigger the radiation dose-optimization process [ 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. As the radiation used in radiological examinations is the source of signal, a reduction of the radiation amount results in a decrease of signal strength and an increase of image noise.…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence for Radiation Dose Optimization in Pediatric Radiology: A Systematic Review

2022

Children

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Radiation dose optimization is particularly important in pediatric radiology, as children are more susceptible to potential harmful effects of ionizing radiation. However, only one narrative review about artificial intelligence (AI) for dose optimization in pediatric computed tomography (CT) has been published yet. The purpose of this systematic review is to answer the question “What are the AI techniques and architectures introduced in pediatric radiology for dose optimization, their specific application areas, and performances?” Literature search with use of electronic databases was conducted on 3 June 2022. Sixteen articles that met selection criteria were included. The included studies showed deep convolutional neural network (CNN) was the most common AI technique and architecture used for dose optimization in pediatric radiology. All but three included studies evaluated AI performance in dose optimization of abdomen, chest, head, neck, and pelvis CT; CT angiography; and dual-energy CT through deep learning image reconstruction. Most studies demonstrated that AI could reduce radiation dose by 36–70% without losing diagnostic information. Despite the dominance of commercially available AI models based on deep CNN with promising outcomes, homegrown models could provide comparable performances. Future exploration of AI value for dose optimization in pediatric radiology is necessary due to small sample sizes and narrow scopes (only three modalities, CT, positron emission tomography/magnetic resonance imaging and mobile radiography, and not all examination types covered) of existing studies.

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Local Diagnostic Reference Levels for X-Ray Examinations in an Australian Tertiary Hospital

Cited by 2 publications

References 14 publications

Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study

Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study

Artificial Intelligence for Radiation Dose Optimization in Pediatric Radiology: A Systematic Review

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