Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Mar 11;13(6):1072.
doi: 10.3390/diagnostics13061072.

Systematic Review on Diagnostic Reference Levels for Computed Tomography Examinations in Radiation Therapy Planning

Shreekripa Rao  1 , Krishna Sharan  2 , Suresh Sukumar  3 , Srinidhi Gururajarao Chandraguthi  2 , Rechal Nisha Dsouza  1 , Leena R David  3   4 , Sneha Ravichandran  3 , Berna Uzun  5   6   7 , Rajagopal Kadavigere  8 , Dilber Uzun Ozsahin  4   6
Affiliations
Review

Systematic Review on Diagnostic Reference Levels for Computed Tomography Examinations in Radiation Therapy Planning

Shreekripa Rao et al. Diagnostics (Basel). .

Abstract

Background: In August 2017, the European Commission awarded the "European Study on Clinical Diagnostic Reference Levels (DRL) for X-ray Medical Imaging" project to the European Society of Radiology to provide up-to-date Diagnostic Reference Levels based on clinical indications. This work aimed to conduct an extensive literature review by analyzing the most recent studies published and the data provided by the National Competent Authorities to understand the current situation regarding Diagnostic Reference Levels based on clinical indications for Radiation Therapy Computed Tomography. Objective: To review the literature on established DRLs and methodologies for establishing Diagnostic reference levels in radiation therapy planning computed tomography (RTCT). Methods: Eligibility criteria: A cohort study (observational design) reporting DRLs in adult patients undergoing computed tomography (CT) for radiation therapy for the region head and neck or pelvis were included. The comprehensive literature searches for the relevant studies published between 2000 and 2021 were performed using PubMed, Scopus, CINHAL, Web of Science, and ProQuest. Results: Three hundred fifty-six articles were identified through an extensive literature search. Sixty-eight duplicate reports were removed. The title and abstract of 288 studies were assessed and excluded if they did not meet the inclusion criteria. Sixteen of 288 articles were selected for full-text screening (studies conducted between 2000 and 2021). Five articles were included in the review after the full-text screening. Conclusions: A globally approved standard protocol that includes scanning techniques, dose measurement method, and DRL percentile needs to be established to make a valuable and accurate comparison with international DRLs.

Keywords: CTDIvol; DLP; diagnostic reference levels; head and neck; pelvis; radiotherapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow-Chart.
Figure 2
Figure 2
CCTA DRLs in Saudi Arabia compared with other international DRLs.
Figure 3
Figure 3
Comparison of mAs between Siemens CT unit and Philips CT unit.
See this image and copyright information in PMC

References

    1. Goske M.J. Diagnostic reference ranges and the American College of Radiology Dose Index Registry: The pediatric experience. Pediatr. Radiol. 2014;44:506–510. doi: 10.1007/s00247-014-3030-0. - DOI - PubMed
    1. Božanić A., Šegota D., Debeljuh D.D., Kolacio M., Radojčić S., Ružić K., Budanec M., Kasabašić M., Hrepić D., Zujić P.V., et al. National reference levels of CT procedures dedicated for treatment planning in radiation oncology. Phys. Med. 2022;96:123–129. doi: 10.1016/j.ejmp.2022.03.001. - DOI - PubMed
    1. Aroua A., Samara E.-T., Bochud F.O., Meuli R., Verdun F.R. Exposure of the Swiss population to computed tomography. BMC Med. Imaging. 2013;13:22. doi: 10.1186/1471-2342-13-22. - DOI - PMC - PubMed
    1. Shrimpton P.C., Hillier M.C., Lewis M.A., Dunn M. National survey of doses from CT in the UK: 2003. Br. J. Radiol. 2006;79:968–980. doi: 10.1259/bjr/93277434. - DOI - PubMed
    1. Bernier M.-O., Baysson H., Pearce M., Moissonnier M., Cardis E., Hauptmann M., Struelens L., Dabin J., Johansen C., Journy N., et al. Cohort Profile: The EPI-CT study: A European pooled epidemiological study to quantify the risk of radiation-induced cancer from paediatric CT. Leuk. Res. 2018;48:379–381g. doi: 10.1093/ije/dyy231. - DOI - PMC - PubMed