Nigerian Radiographers Obligation to Diagnostic Reference levels (DRLs) in Medical Imaging

Abstract

Background: Diagnostic reference levels (DRLs) help to identify unusually high dose levels in medical procedures involving radiation. This will subsequently, stimulate quality control. There are legislations and guidelines requiring the Member States of the European Union to adopt DRLs. While about 72% of European countries, as well as the United States, have complied, and with subsequent reviews demonstrating significant dose reductions (16% – 30%), no evidence links any African country to replicate the same.
 Objective: This work briefly reviewed the progress of Nigeria with regards to diagnostic reference levels (DRLs) and with particular attention to efforts by radiographers.
 Methods: Google search was made with keywords of diagnostic reference levels as well as radiation dose in Nigeria. Over forty works were retrieved but only twenty- two which had specific relevance to the focus of the review were archived and read. The works were subsequently scrutinized to piece together the trend of DRLs globally, and locally.
 Results: Publications on x-ray, mammography, fluoroscopy and computed tomography dose abound in Nigeria. Doses had wide variations in all modalities. There was no accessible evidence to indicate that any regulatory agency in Nigeria had keyed into the imperative of dose investigation, monitoring and reporting.
 Conclusion: In conclusion, diagnostic reference levels in x-ray, mammography and computed tomography have been recommended by independent researchers in Nigeria. Regulatory agencies are urged to summon the will to give guidelines on the implementation of these DRLs in order to improve the optimization of protection for patients.

Proposed Institutional Diagnostic Reference Levels in Computed and Direct Digital Radiography Examinations in Two Teaching Hospitals

“…DRLs are an investigational tool used to identify high patient radiation doses which require corrective action if consistently exceeded. Dose reduction of about 16.0% to 30.0% [18] had been achieved due to the introduction of DRLs in the United States. However, in Africa, no evidence exists from any country showing the establishment of national DRLs [18].…”

“…Dose reduction of about 16.0% to 30.0% [18] had been achieved due to the introduction of DRLs in the United States. However, in Africa, no evidence exists from any country showing the establishment of national DRLs [18].…”