Abstract
The radiation dose delivered to patients undergoing specific medical x-ray examinations might vary among practices due to the difference in energy, filtration, and technique used to acquire images. In order to minimize this variation, the Diagnostic Reference Level (DRL) was introduced by ICRP in 1996 in publication no.73 as a standard reference dose in medical imaging practice. DRL can be used to promote an optimum range of doses to acquire diagnostic images for specified procedures. The implementation of DRL will be effective only if dose monitoring is regularly conducted, and corrective actions are performed if the doses consistently exceed DRL values. While many studies on DRLs have been published, the concept of DRLs and its implementation might not be familiar to all medical radiation professionals, especially for those who do not have national standard. Therefore, this article is expected to give comprehensive and useful guidelines for medical radiation practitioners regarding DRL in order to promote the establishment and effective implementation of DRL. This article will explore the current literature related to the definition of DRL, steps in establishing DRL, various studies on DRLs, and DRL in paediatric.
Keywords: Diagnostic Reference Level, dose optimisation.
References
- ICRP, “Radiological Protection in Medicine. Annals ICRP Publication 105,” 2007.
- UNSCEAR, “Sources and Effects of Ionising Radiation,” United Nations, New York, 2000.
- A. Johnston and P. C. Brennan, “Reference dose levels for patients undergoing common diagnostic x-ray examinations in Irish hospitals,” The british Journal Of Radiology, pp. 396-402, 2000.
- Seeram and P. Brennan, Radiation protection in Diagnostic X-ray Imaging, Burlington: Jones & Bartlett, 2017.
- ICRP, “Radiological Protection and safety in medicine: ICRP Publication 73,” 1996.
- ARPANSA, “National Diagnostic Reference Level Service in more detail,” 17 November 2018. [Online]. Available: https://www.arpansa.gov.au/research-and-expertise/surveys/national-diagnostic-reference-level-service/in-more-detail.
- Medical Council, “Diagnostic Reference Level: Position Paper,” 18 November 2004. [Online]. Available: https://www.medicalcouncil.ie/About-Us/Legislation/Medical-Ionising-Radiation/Diagnostic-Reference-Levels.pdf.
- Commission, “European guidelines on diagnostic criteria,” 1996.
- Vassileva and Madan Rehani, “Diagnostic Reference level,” American Journal of Radiology, pp. 204 W1-W3, 2015.
- G. A. Berrington, M. Mahesh, K. P. Kim, M. Bhargavan, R. Lewis and F. Mettler, “Projected cancer risks from computed tomographic scans performed in the United States in 2007,” Arch Intern Med, pp. 2071-2077, 2009.
- Hall and D. J. Brenner, “Cancer risks from diagnostic radiology,” British Journal of Radiology, pp. 362-378, 2008.
- J. Foley, M. F. McEntee and L. A. Rainford, “Establishment of CT diagnostic reference levels in Ireland,” The British Journal of Radiology, pp. 1390-1397, 2012.
- ARPANSA, “Current Australian national diagnostic reference levels for multi detector computed tomography,” 17 November 2018. [Online]. Available: https://www.arpansa.gov.au/research-and-expertise/surveys/national-diagnostic-reference-level-service/current-australian-drls-update/mdct.
- ARPANSA, “Multi detector computed tomography statistics,” 17 November 2012. [Online]. Available: https://www.arpansa.gov.au/research-and-expertise/surveys/national-diagnostic-reference-level-service/mdct/statistics#superseded.
- European Commission, Radiation Protection No.185, Louxembourg: European Union, 2018.
- Hart, B. Hillier and M. Wall, “National reference doses for common radiographic, fluoroscopic and dental X-ray examinations in the UK,” British Journal Of Radiology, pp. 1-2, 2009.
Corresponding Author
Putu Irma Wulandari
Akademi Teknik Radiodiagnostik dan Radioterapi (ATRO) Bali
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.80
