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Multicenter Study
. 2021 Jul;31(7):4459-4469.
doi: 10.1007/s00330-020-07652-5. Epub 2021 Jan 15.

CT diagnostic reference levels based on clinical indications: results of a large-scale European survey

Virginia Tsapaki  1 , John Damilakis  2 , Graciano Paulo  3 , Alexander A Schegerer  4   5 , Jacques Repussard  6 , Werner Jaschke  7 , Guy Frija  8
Affiliations
Multicenter Study

CT diagnostic reference levels based on clinical indications: results of a large-scale European survey

Virginia Tsapaki et al. Eur Radiol. 2021 Jul.

Abstract

Objectives: The objective of this study was to investigate the feasibility of defining diagnostic reference levels (DRLs) on a European basis for specific clinical indications (CIs), within the context of the European Clinical DRLs (EUCLID) European Commission project.

Methods: A prospective, multicenter, industry-independent European study was performed to provide data on 10 CIs (stroke, chronic sinusitis, cervical spine trauma, pulmonary embolism, coronary calcium scoring, coronary angiography, lung cancer, hepatocellular carcinoma, colic/abdominal pain, and appendicitis) via an online survey that included information on patient clinical, technical, and dosimetric parameters. Data from at least 20 patients per CI were requested from each hospital. To establish DRLs, a methodology in line with the International Commission on Radiological Protection (ICRP) Report 135 good practice recommendations was followed.

Results: Data were collected from 19 hospitals in 14 European countries on 4299 adult patients and 10 CIs to determine DRLs. DRLs differ considerably between sites for the same CI. Differences were attributed mainly to technical protocol and variable number of phases/scan lengths. Stroke and hepatocellular carcinoma were the CIs with the highest DRLs. Coronary calcium scoring had the lowest DRL value. Comparison with published literature was limited, as there was scarce information on DRLs based on CI.

Conclusions: This is the first study reporting on feasibility of establishing CT DRLs based on CI using European data. Resulting values will serve as a baseline for comparison with local radiological practice, national authorities when DRLs are set/updated, or as a guideline for local DRL establishment.

Key points: • First study reporting on the feasibility of establishing CT diagnostic reference levels based on clinical indication using data collected across Europe. • Only one-fourth of the hospitals had CT machines less than 5 years old. • Large dose variations were observed among hospitals and CT protocols were quite different between hospitals.

Keywords: Patient safety; Radiation exposure; Tomography scanners, X-ray computed.

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References

    1. Mazonakis M, Damilakis J (2016) Computed tomography: what and how does it measure? Eur J Radiol 85(8):1499–1504 - DOI
    1. Revel MP, Petrover D, Hernigou A, Lefort C, Meyer G, Frija G (2005) Diagnosing pulmonary embolism with four-detector row helical CT: prospective evaluation of 216 outpatients and inpatients. Radiology 234(1):265–273 - DOI
    1. Flohr T (2016) 40 years of computed tomography - a retrospect and current developments. Z Med Phys 26(3):195–196 - DOI
    1. Ginat DT, Gupta R (2014) Advances in computed tomography imaging technology. Annu Rev Biomed Eng 16:431–453 - DOI
    1. Runge VM, Marquez H, Andreisek G, Valavanis A, Alkadhi H (2015) Recent technological advances in computed tomography and the clinical impact therein. Invest Radiol 50(2):1191–1227 - DOI

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