National Diagnostic Reference Level Initiative for Computed Tomography Examinations in Kenya

Korir, Geoffrey K; Wambani, Jeska S.; Korir, Ian K.; Tries, Mark A.; Boen, P Kipchirchir

doi:10.1093/rpd/ncv020

Cited by 23 publications

(44 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study DRLs France 2011 [7] Kenya 2015 [8] Iran 2015 [6] CT there was a significant increase in patient-dose with the increase in the number of detectors.…”

Section: Machinesmentioning

confidence: 77%

See 1 more Smart Citation

Diagnostic Reference Levels of Adults CT-Scan Imaging in Cameroon: A Pilot Study of Four Commonest CT-Protocols in Five Radiology Departments

Moifo¹,

Tapouh²,

Guena³

et al. 2017

OJMI

View full text Add to dashboard Cite

CT-scan is the most irradiating tool in diagnostic radiology. For 5% -10% of diagnostic X-ray procedures, it is responsible for 34% of irradiation according to UNSCEAR. Patients radiation protection must therefore be increased during CT-scan procedures. This requires the rigorous application of optimization principle which imposes to have "diagnostic reference levels". Objective: The aim of this study was to determine the diagnostic reference levels (DRLs) of the four most frequent CT-scans examinations of adults in Cameroon. Material and Method: It was a cross-sectional pilot study carried out from April to September 2015 in five health facilities using CT-scan in Cameroon. The studied variables were: patients age and sex, type of CT-scan examination (cerebral, chest, abdomino-pelvic, lumbar spine), Used of IV contrast (IV−/ IV+), acquisition length, time of tube rotation, voltage (kV), mAs, pitch, thickness of slices, CTDIvol and DLP. For each type of examination, at least 30 patients were included per center, consecutively on the randomly predetermined days. The DRL for each type of examination was defined as the 75th percentile of its PDL and CTDIvol. Results: Of the 696 examinations, 41.2% were cerebral, 26.9% abdomino-pelvic, 17.7% lumbar spine and 14.2% chest. •cm] respectively for cerebral, lumbar spine, abdominopelvic and chest CT-scans. Taking in consideration the number of detectors, the 75th percentile of the Dose-Length product decreased with the increase number of detectors for cerebral examinations but was the highest with 16 MDCT for the abdominopelvic, lumbar spine and chest CT-scans. For the chest and lumbar spine examinations, there was a significant increase in patient-dose with the increase in the number of detectors. Conclusion: Our DRLs values lie between the norms of some European countries and those of some African countries. There is remarquable variation in dose for the commonest CTscans examinations in Cameroon, requiring then an optimization process from these determined DRLs and establishment of national DRLs. Special attention to optimization should be paid when using 16 MDCT.

show abstract

“…Our study DRLs France 2011 [7] Kenya 2015 [8] Iran 2015 [6] CT there was a significant increase in patient-dose with the increase in the number of detectors.…”

Section: Machinesmentioning

confidence: 77%

“…Higher DRLs are observed on cerebral CT-scans as in Iran, Kenya and France [6] [7] [8]; this can be explained by the presence of numerous high attenuating bony structures in the skull requiring the application of high doses for adequate images quality.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Reference Levels of Adults CT-Scan Imaging in Cameroon: A Pilot Study of Four Commonest CT-Protocols in Five Radiology Departments

Moifo¹,

Tapouh²,

Guena³

et al. 2017

OJMI

View full text Add to dashboard Cite

show abstract

“…The association between dose and patient size may be used to adjust CT protocols for a specific patient [9]. Standardized CT measurements used to set up DRLs are the volume CT dose index (CTDI vol ) and dose-length product (DLP) [10,11]. Several studies reported that DRL had been used in certain countries for quality assurance and CT dose optimization [12,13].…”

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

View full text Add to dashboard Cite

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.

show abstract

“…An independent sample t-test indicated no significant difference in the CTDI vol at the 75 th per- centile (p=0.199). The results of a comparison of this study's CTDI vol at the 75 th percentile for CT unit A with the European Commission states (EC) (p=0.266), [15] the USA (p=0.199), [16] Ireland (p=0.185), [17] Switzerland (p=0.210), [18] Germany (p=0.221), [19] Kenya (p=0.218), [20] and Nigeria (p=0.215) [21] was not significant. The comparison of the CTDI vol at the 75 th percentile for CT unit B with the EC group (p=0.531), the USA (p=0.940), Ireland (p=0.933), Switzerland (p=0.968), Germany (p=0.892), Kenya (p=0.848), and Nigeria (p=0.872) also yielded no statistically significant difference ( Table 2).…”

Section: Resultsmentioning

confidence: 99%

Patient dose estimation using CT-EXPO software at two hospitals in north-central Nigeria

Ekpo¹

2018

South Clin Ist Euras

View full text Add to dashboard Cite

Simulation software has aided the estimation of organ dose from computed tomography (CT) examinations. The aim of this study was to use the CT-Expo (SASCRAD, Fritz-Reuter-Weg, Buchholz, Germany) software to determine volume CT dose index (CTDI vol), dose length product (DLP), organ dose and effective dose. Methods: A total of 171 patient data were retrieved from a Toshiba Aquillion 16-slice CT scanner (Toshiba Corp., Tokyo, Japan) representing CT unit A and a Philips Brilliance 16-slice CT scanner (Konin klijke Philips N.V., Amsterdam, Netherlands) representing CT unit B and a CT-Expo spreadsheet was used to estimate the dose delivered. Results: Head CT scans were the most frequently seen (64%) at the 2 facilities studied. The CT parameters of peak kilovoltage (kVp) and pitch between the 2 units were statistically different (p<0.05). There was no significant difference in CTDI vol between CT unit A and B (p=0.199). A comparison of CTDI vol and DLP of CT units A and B with other studies revealed no statistically significant difference (p<0.05). The mean effective dose (E) for the abdomen was greater compared with other studies, but without a statistically significant difference (p<0.05). Furthermore, no significant difference in organ dose was seen between CT units A and B (p=0.677). A comparison of organ dose with other studies indicated no relevant difference (p<0.05). Conclusion: The CT-Expo software showed good results with the imPACT software (ImPACT scanner evaluation group, London, UK). CT unit A had greater differences in CTDI vol and DLP compared with unit B. This difference could be associated with the significant difference seen in the kVp and pitch of both scanners.

show abstract

National Diagnostic Reference Level Initiative for Computed Tomography Examinations in Kenya

Cited by 23 publications

References 33 publications

Diagnostic Reference Levels of Adults CT-Scan Imaging in Cameroon: A Pilot Study of Four Commonest CT-Protocols in Five Radiology Departments

Diagnostic Reference Levels of Adults CT-Scan Imaging in Cameroon: A Pilot Study of Four Commonest CT-Protocols in Five Radiology Departments

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

Patient dose estimation using CT-EXPO software at two hospitals in north-central Nigeria

Contact Info

Product

Resources

About