Local Diagnostic Reference Levels (LDRLs) for routine X-ray examinations in Morocco

Abstract

In Morocco, the radiation protection of patients undergoing medical imaging examinations using ionizing radiation sources is now governed by specific provisions of Chapter VII of Law no142-12 (Loi no142-12 – AMSSNuR, 2015). The principle of justification of procedures and the principle of optimization of doses delivered constitute the basis of the legislation governing medical exposure. DRLs are considered as an important optimization tool encouraging healthcare professionals to optimize their practice and assure a better patient safety. In this survey, Local Diagnostic Reference Levels (LDRLs) were established for the eight most frequent examinations in Morocco. Data from 1747 patients were collected from seven regional hospitals. The proposed LDRLs were defined as the 75th percentile of the mean entrance surface dose distribution (ESD) in mGy using the indirect dosimetry method according to the IAEA Report Series No. 457. The LDRLs values reported in this study were for the eight examinations: skull (PA) 2.8 mGy, chest (PA) 0.51 mGy, abdomen (AP) 7.6 mGy, pelvis (AP) 6.45 mGy, lumbar (AP) 7.8 mGy, lumbar (Lat) 10.7 mGy, cervical (AP) 2.2 mGy, and cervical (Lat) 2.4 mGy. The DRLs reported in Morocco were compared with those of international authorities and other countries: IRSN (France), NRPB (UK), Japan, Sudan, and Iran. The present work assesses the local DRLs in Morocco and constitutes a starting point that will provide professionals with a tool to help them optimize the doses delivered to patients. Furthermore, the definition of national DRLs by radiography is an essential step in the process of optimizing medical exposures.

La relation linéaire sans seuil (LNT) et l’évolution du système de radioprotection

“…While waiting for this revision of the ICRP recommendations, the LNT and the three main principles associated with, namely, the justification, the reduction and the limitation of exposures, highly fruitful in the management of exposures, shall continue to drive the actions of the radiation protection community. Thus, the optimization of medical exposure through the use of diagnostic reference levels (Talbi et al, 2022;El Mansouri et al, 2022;Nassar et al, 2023) especially for the most sensitive pediatric population (Bawazeer et al, 2022;Habib Geryes et al, 2022;Khajmi et al, 2023) should remain a priority, since medical exposures, as a mean, represent the first source of exposure for populations living in developed countries. We thus thank our authors who, through their publications, contribute to the evolution of the radiological protection system.…”