TY - JOUR
T1 - Diagnostic reference levels and median doses for common clinical indications of CT
T2 - findings from an international registry
AU - Bos, Denise
AU - Yu, Sophronia
AU - Luong, Jason
AU - Chu, Philip
AU - Wang, Yifei
AU - Einstein, Andrew J.
AU - Starkey, Jay
AU - Delman, Bradley N.
AU - Duong, Phuong Anh T.
AU - Das, Marco
AU - Schindera, Sebastian
AU - Goode, Allen R.
AU - MacLeod, Fiona
AU - Wetter, Axel
AU - Neill, Rebecca
AU - Lee, Ryan K.
AU - Roehm, Jodi
AU - Seibert, James A.
AU - Cervantes, Luisa F.
AU - Kasraie, Nima
AU - Pike, Pavlina
AU - Pahwa, Anokh
AU - Jeukens, Cécile R.L.P.N.
AU - Smith-Bindman, Rebecca
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2022/3
Y1 - 2022/3
N2 - Objectives: The European Society of Radiology identified 10 common indications for computed tomography (CT) as part of the European Study on Clinical Diagnostic Reference Levels (DRLs, EUCLID), to help standardize radiation doses. The objective of this study is to generate DRLs and median doses for these indications using data from the UCSF CT International Dose Registry. Methods: Standardized data on 3.7 million CTs in adults were collected between 2016 and 2019 from 161 institutions across seven countries (United States of America (US), Switzerland, Netherlands, Germany, UK, Israel, Japan). DRLs (75th percentile) and median doses for volumetric CT-dose index (CTDIvol) and dose-length product (DLP) were assessed for each EUCLID category (chronic sinusitis, stroke, cervical spine trauma, coronary calcium scoring, lung cancer, pulmonary embolism, coronary CT angiography, hepatocellular carcinoma (HCC), colic/abdominal pain, appendicitis), and US radiation doses were compared with European. Results: The number of CT scans within EUCLID categories ranged from 8,933 (HCC) to over 1.2 million (stroke). There was greater variation in dose between categories than within categories (p <.001), and doses were significantly different between categories within anatomic areas. DRLs and median doses were assessed for all categories. DRLs were higher in the US for 9 of the 10 indications (except chronic sinusitis) than in Europe but with a significantly higher sample size in the US. Conclusions: DRLs for CTDIvol and DLP for EUCLID clinical indications from diverse organizations were established and can contribute to dose optimization. These values were usually significantly higher in the US than in Europe. Key Points: • Registry data were used to create benchmarks for 10 common indications for CT identified by the European Society of Radiology. • Observed US radiation doses were higher than European for 9 of 10 indications (except chronic sinusitis). • The presented diagnostic reference levels and median doses highlight potentially unnecessary variation in radiation dose.
AB - Objectives: The European Society of Radiology identified 10 common indications for computed tomography (CT) as part of the European Study on Clinical Diagnostic Reference Levels (DRLs, EUCLID), to help standardize radiation doses. The objective of this study is to generate DRLs and median doses for these indications using data from the UCSF CT International Dose Registry. Methods: Standardized data on 3.7 million CTs in adults were collected between 2016 and 2019 from 161 institutions across seven countries (United States of America (US), Switzerland, Netherlands, Germany, UK, Israel, Japan). DRLs (75th percentile) and median doses for volumetric CT-dose index (CTDIvol) and dose-length product (DLP) were assessed for each EUCLID category (chronic sinusitis, stroke, cervical spine trauma, coronary calcium scoring, lung cancer, pulmonary embolism, coronary CT angiography, hepatocellular carcinoma (HCC), colic/abdominal pain, appendicitis), and US radiation doses were compared with European. Results: The number of CT scans within EUCLID categories ranged from 8,933 (HCC) to over 1.2 million (stroke). There was greater variation in dose between categories than within categories (p <.001), and doses were significantly different between categories within anatomic areas. DRLs and median doses were assessed for all categories. DRLs were higher in the US for 9 of the 10 indications (except chronic sinusitis) than in Europe but with a significantly higher sample size in the US. Conclusions: DRLs for CTDIvol and DLP for EUCLID clinical indications from diverse organizations were established and can contribute to dose optimization. These values were usually significantly higher in the US than in Europe. Key Points: • Registry data were used to create benchmarks for 10 common indications for CT identified by the European Society of Radiology. • Observed US radiation doses were higher than European for 9 of 10 indications (except chronic sinusitis). • The presented diagnostic reference levels and median doses highlight potentially unnecessary variation in radiation dose.
KW - Adult
KW - Diagnostic reference levels
KW - Registries
KW - Tomography, X-ray computed
KW - United States
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UR - http://www.scopus.com/inward/citedby.url?scp=85116998142&partnerID=8YFLogxK
U2 - 10.1007/s00330-021-08266-1
DO - 10.1007/s00330-021-08266-1
M3 - Article
C2 - 34642811
AN - SCOPUS:85116998142
SN - 0938-7994
VL - 32
SP - 1971
EP - 1982
JO - European Radiology
JF - European Radiology
IS - 3
ER -