Rationale for National and Local Dose Reference Levels and Collective Effective Dose in CT

Purpose: This article is intended as a review of the methods of establishing dose reference levels (DRLs) in relation to computerized tomography (CT) and their role in the standardization and auditing of radiation dose in CT. Discussion: CT is considered a high radiation dose examination. The potential for dose reduction resulting from the establishment of DRLs is discussed. The rationale for the use of DRLs in relation to the use of appropriate radiation measurements and CT dose descriptors are discussed. The estimation of the radiation risk to the irradiated individual is given by the effective dose, which takes into consideration the type of radiation and the radiosensitivity of the irradiated tissues. The collective dose is used to describe the radiation exposure of a population from low doses of different sources of radiation. Conclusion: Dose comparison between individual imaging sites is a vital part of DRL establishment and facilitates standardization of radiation dose levels for patients attending for a CT examination. Measurements of both effective and collective dose are difficult to achieve in practice. CT dose descriptors such as CT dose index and dose length product provide the means of comparing and monitoring the effect of optimized CT scanning protocols on the radiation dose.