{"id":46083,"date":"2025-09-30T03:10:00","date_gmt":"2025-09-30T03:10:00","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/46083\/"},"modified":"2025-09-30T03:10:00","modified_gmt":"2025-09-30T03:10:00","slug":"optimizing-radiation-safety-establishment-of-diagnostic-reference-levels-for-ct-examinations-in-northern-jordan-egyptian-journal-of-radiology-and-nuclear-medicine","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/46083\/","title":{"rendered":"Optimizing radiation safety: establishment of diagnostic reference levels for CT examinations in Northern Jordan | Egyptian Journal of Radiology and Nuclear Medicine"},"content":{"rendered":"<p>Upon examining the mean values across facilities, significant differences were observed in brain CT examinations, particularly in the DLP, with the most substantial disparity between the minimum and maximum dose values Fig.\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig2\" rel=\"nofollow noopener\" target=\"_blank\">2<\/a>. In contrast, the variation in brain CTDIvol values was minimal, with the mean maximum and minimum recorded at 68 and 142 mGycm Fig.\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig1\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a>. The noticeable discrepancy in brain CTDIvol, especially between scanners Toshiba 16 and Siemens 64, can be attributed to differences in brain CT scan protocols. For example, Toshiba 16 CT scanner used an average of 173 mAs, while Siemens 64 CT scanner employed 111 mAs for brain examinations. Even among scanners of the same brand, such as Philips 64-slice scanners, variations in DLP were noted. The largest dose difference was observed in the brain CT protocol between GE 16 and Siemens 16. Both scanners were of the same slice number, yet GE 16 used 165\u00a0mAs, while Siemens 16 used 250\u00a0mAs, contributing to the observed difference in DLP (Figs.\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig1\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig2\" rel=\"nofollow noopener\" target=\"_blank\">2<\/a>).<\/p>\n<p>Fig.\u00a01<a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3\/figures\/1\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig1\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/09\/43055_2025_1600_Fig1_HTML.png\" alt=\"figure 1\" loading=\"lazy\" width=\"685\" height=\"437\"\/><\/a><\/p>\n<p>Comparison between CTDIvol of different scanners<\/p>\n<p>Fig.\u00a02<a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3\/figures\/2\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig2\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/09\/43055_2025_1600_Fig2_HTML.png\" alt=\"figure 2\" loading=\"lazy\" width=\"685\" height=\"343\"\/><\/a><\/p>\n<p>Comparison between DLP of different scanners<\/p>\n<p>In the case of CT chest, the 75th percentile of the median DLP value significantly exceeded those of all countries in Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>, registering at 662\u00a0mGy.cm, with proximity to Japan and Canada. Conversely, the 75th percentile of the median CTDIvol (16\u00a0mGy) closely approximated the values for Japan and Australia (15\u00a0mGy) [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 14\" title=\"Yonekura Y (2015) Diagnostic reference levels based on latest surveys in Japan. Japan DRLs Report\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR14\" id=\"ref-link-section-d84443128e2475\" rel=\"nofollow noopener\" target=\"_blank\">14<\/a>] (Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>). Similarly, for CT brain, the 75th percentile CTDIvol (76\u00a0mGy) surpassed values from other studies except Canada and Japan, while the 75th percentile of the median DLP (1320.2 mGy.cm) slightly exceeded Japan\u2019s (1350\u00a0mGy.cm) [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 14\" title=\"Yonekura Y (2015) Diagnostic reference levels based on latest surveys in Japan. Japan DRLs Report\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR14\" id=\"ref-link-section-d84443128e2481\" rel=\"nofollow noopener\" target=\"_blank\">14<\/a>], attributed to differences in scan length. Regarding CT abdomen, the 75th percentiles of the median for CTDIvol (23 mGy) and DLP (1010 mGy.cm) surpassed those of Portugal and India [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 9\" title=\"Santos J, Foley S, Paulo G, McEntee MF, Rainford L (2014) The establishment of computed tomography diagnostic reference levels in Portugal. Radiat Prot Dosimetry 158(3):307\u2013317. &#010;                  https:\/\/doi.org\/10.1093\/rpd\/nct226&#010;                  &#010;                \" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR9\" id=\"ref-link-section-d84443128e2484\" rel=\"nofollow noopener\" target=\"_blank\">9<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 10\" title=\"Saravanakumar A, Vaideki K, Govindarajan K, Jayakumar S (2014) Establishment of diagnostic reference levels in computed tomography for select procedures in Pudhuchery, India. J Med Phys\/Assoc Med Phys India 39(1):50. &#010;                  https:\/\/doi.org\/10.4103\/0971-6203.125509&#010;                  &#010;                \" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR10\" id=\"ref-link-section-d84443128e2488\" rel=\"nofollow noopener\" target=\"_blank\">10<\/a>].<\/p>\n<p>Table\u00a04 Comparison with other studies<\/p>\n<p>Figures\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig3\" rel=\"nofollow noopener\" target=\"_blank\">3<\/a>, <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a> and <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Fig5\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a> present a juxtaposition of DRL, revealing substantial elevations compared to international standards Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>. The premise underlying the studies mentioned below is that CT examinations conducted in northern Jordanian hospitals warrant reassessment for dose optimization. This, however, necessitates a nuanced consideration of multiple variables, encompassing the make and version of CT scanners, patient dimensions across various nations, image quality, (kVp) settings, slice thickness, and the approach to statistical analysis.<\/p>\n<p>Fig.\u00a03<a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3\/figures\/3\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig3\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/09\/43055_2025_1600_Fig3_HTML.png\" alt=\"figure 3\" loading=\"lazy\" width=\"685\" height=\"301\"\/><\/a><\/p>\n<p>Comparison of CTDIvol (mGy) for brain with other studies<\/p>\n<p>Fig.\u00a04<a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3\/figures\/4\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig4\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/09\/43055_2025_1600_Fig4_HTML.png\" alt=\"figure 4\" loading=\"lazy\" width=\"685\" height=\"268\"\/><\/a><\/p>\n<p>Comparison of DLP (mGy.cm) for chest with other studies<\/p>\n<p>Fig.\u00a05<a class=\"c-article-section__figure-link\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\" href=\"https:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3\/figures\/5\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" aria-describedby=\"Fig5\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/09\/43055_2025_1600_Fig5_HTML.png\" alt=\"figure 5\" loading=\"lazy\" width=\"685\" height=\"278\"\/><\/a><\/p>\n<p>Comparison of CTDIvol (mGy) and DLP (mGy.cm) for abdomen examination with other studies<\/p>\n<p>Variability in radiation dose could occur due to differences in scanner manufacturing and examination protocols, as noted in previous studies [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 3\" title=\"Foley SJ, McEntee MF, Rainford LA (2012) Establishment of CT diagnostic reference levels in Ireland. Br J Radiol 85(1018):1390\u20131397. &#010;                  https:\/\/doi.org\/10.1259\/bjr\/15839549&#010;                  &#010;                \" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR3\" id=\"ref-link-section-d84443128e3011\" rel=\"nofollow noopener\" target=\"_blank\">3<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 6\" title=\"Martin CJ, Vano E (2017) Diagnostic reference levels and optimization in radiology: where do we go from here? J Radiol Protect 38(1)\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR6\" id=\"ref-link-section-d84443128e3014\" rel=\"nofollow noopener\" target=\"_blank\">6<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 13\" title=\"Sulieman A, Elnour A, Mahmoud M, Alkhorayef M, Hamid O, Bradley D (2020) Diagnostic reference level for computed tomography abdominal examinations: a multicentre study. Radiat Phys Chem 174:108963. &#010;                  https:\/\/doi.org\/10.1016\/j.radphyschem.2020.108963&#010;                  &#010;                \" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#ref-CR13\" id=\"ref-link-section-d84443128e3017\" rel=\"nofollow noopener\" target=\"_blank\">13<\/a>]. Moreover, the data collection did not consider the study indications, potentially influencing scan parameters and consequently affecting the results of DLP. Additionally, the statistical analysis did not incorporate patient weight as this information is typically not documented by radiology technologists during procedures.<\/p>\n<p>Table <a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a> presents the comparison between current results and DRL from other nations. While the median DRL values for chest CT and brain CT align within acceptable ranges compared to national DRL Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>, the median value of dose descriptors for abdomen CT surpasses those of other studies listed in Table\u00a0<a data-track=\"click\" data-track-label=\"link\" data-track-action=\"table anchor\" href=\"http:\/\/ejrnm.springeropen.com\/articles\/10.1186\/s43055-025-01600-3#Tab4\" rel=\"nofollow noopener\" target=\"_blank\">4<\/a>. Median CTDIvol and DLP values were 19.5 mGy and 863\u00a0mGy.cm, respectively, exceeding those for CT abdomen in Portugal and India (13.9 mGy, 562.7\u00a0mGy.cm, and 13\u00a0mGy, 427\u00a0mGy.cm). Consistent findings arise when comparing 75th percentile of the median values with international DRLs. For CTDIvol, brain CT, chest CT, and abdomen CT exhibit doses of 76, 16, and 24 mGy, respectively. Correspondingly, DLP values stand at 1420 mGy.cm, 531 mGy.cm, and 863 mGy.cm. Both CTDIvol and DLP DRL are higher than those of all countries.<\/p>\n","protected":false},"excerpt":{"rendered":"Upon examining the mean values across facilities, significant differences were observed in brain CT examinations, particularly in the&hellip;\n","protected":false},"author":2,"featured_media":46084,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[114,36315,36318,36319,85,35083,35084,46,36316,21751,36317],"class_list":["post-46083","post","type-post","status-publish","format-standard","has-post-thumbnail","category-business","tag-business","tag-computed-tomography-ct","tag-dose-length-product-dlp","tag-drl","tag-il","tag-imaging-radiology","tag-interventional-radiology","tag-israel","tag-multi-detector-ct","tag-nuclear-medicine","tag-volume-ct-dose-index-ctdivol"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/46083","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=46083"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/46083\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/46084"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=46083"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=46083"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=46083"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}