Establishment of CT diagnostic reference levels in Ireland

Objective: To propose Irish CT diagnostic reference levels (DRLs) by collecting radiation doses for the most commonly performed CT examinations. Methods: A pilot study investigated the most frequent CT examinations. 40 CT sites were then asked to complete a survey booklet to allow the recording of CT parameters for each of 9 CT examinations during a 12-week period. Dose data [CT volume index (CTDI_vol) and dose-length product (DLP)] on a minimum of 10 average-sized patients in each category were recorded to calculate a mean site CTDI_vol and DLP value. The rounded 75th percentile was used to calculate a DRL for each site and the country by compiling all results. Results are compared with international DRL data. Results: Data were collected for 3305 patients. 30 sites responded with data for 34 scanners, representing 54% of the national total. All equipment had multislice capability (2-128 slices). DRLs are proposed using CTDI_vol (mGy) and DLP (mGy cm) for CT head (66/58 and 940, respectively), sinuses (16 and 210, respectively), cervical spine (19 and 420, respectively), thorax (9/11 and 390, respectively), high resolution CT (7 and 280, respectively), CT pulmonary angiography (13 and 430, respectively), multiphase abdomen (13 and 1120, respectively), routine abdomen/pelvis (12 and 600, respectively) and trunk examinations (10/12 and 850, respectively). These values are lower than current DRLs and comparable to other international studies. Wide variations in mean doses are noted across sites. Conclusions: Baseline figures for Irish CT DRLs are provided on the most frequently performed CT examinations. The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimisation of examinations.