Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study.
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Oliveira Bernardo Mônica, Karout Lina, Morgado Flávio, Ebrahimian Shadi, Sarmet Santos Alair, Amorim Clarissa, Muniz Filho Hilton, Moscatelli Antonio, Francisco Muglia Valdair, Schroeder Henrique, Moulin Sales Danilo, Gandolpho Henschel Renan, Giovanni Valese Bruno, Kiipper Felipe, Cesar Cavalcanti Publio, Lucena Ronaldo, Jornada Tiago, de Paula Valnir, Zago Marcel, Varella Ricardo, Anes Mauricio, Márcio Alves Pinheiro Antonio, Claúdio de Moura Carvalho Luiz, Santana de Melo Tapajos Juliana, Antonio de Almeida Fernando, Applegate Kimberly, Paulo Graciano, Roberto Costa Paulo
Аннотация
METHODS: The prospective study included 4787 patients (50 ± 18 years old; male:female 2041:2746) at 13 Brazilian sites that have been submitted to head, paranasal sinus, cervical spine, chest, or abdomen-pelvis CT between January and October 2021 for 13 clinical indications. The sites provided the following information: patient age, gender, weight, height, body mass index[BMI], clinical indications, scanner information(vendor, model, detector configuration), scan parameters (number of scan phases, kV, mA, pitch) and dose-related quantities (CT dose index volume- CTDIvol, dose length product- DLP). Median(AD) and 75th(DRL) percentile CTDIvol and DLP values were estimated for each body region and clinical indications. Non-normal data were analyzed with the Kruskal-Wallis test.
RESULTS: In majority of Brazilian sites, body region and clinical indications based DRLs were at or lower than the corresponding DRLs in the US and higher than Europe. Although radiation doses varied significantly for patients in different body mass index groups (p < 0.001), within each body region, there were no differences in radiation doses for different clinical indications (p > 0.1). Radiation doses for 7/13 clinical indications were higher using iterative reconstruction technique than for the filtered back projection.
CONCLUSIONS: There was substantial variation in Brazil DRLCI across different institutions with higher doses compared to the European standards. There was also a lack of clinical indication-based protocol and dose optimization based on different clinical indications for the same body region.