Establishment of CT diagnostic reference levels (DRLs) for a Singapore healthcare cluster |
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| Affiliation: | 1. Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886;2. Singapore General Hospital, Outram Road Singapore, Singapore 169608;3. National Cancer Centre Singapore, 11 Hospital Crescent, Singapore 169610;4. Kandang Kerbau Hospital, 100 Bukit Timah Road, Singapore 229899;5. Changi General Hospital, 2 Simei Street 3, Singapore 529889;6. National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609;7. National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433;1. Computer Sciences Department, Faculty of Sciences Semlalia, Cadi Ayyad University, Morocco;2. Polydisciplinary Faculty Safi, Cadi Ayyad University, Morocco;1. Tameside & Glossop Integrated Care NHS Foundation Trust, United Kingdom;2. School of Health and Society Allerton Building, University of Salford, Manchester M5 4WT, United Kingdom;1. University of Cumbria, Lancaster, United Kingdom;2. University College Dublin, Ireland;1. Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany;2. Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany;1. Sheffield Hallam University, Sheffield, UK;2. Sonographer at the University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK |
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| Abstract: | IntroductionThe use of computed tomography (CT) in healthcare institutions has increased rapidly in recent years. The Singapore Health Services (SingHealth) cluster of healthcare institutions has taken the first step in establishing a local cluster-wide CT Diagnostic Reference Levels (DRL) in Singapore. CT dose data from each institution were collected through two primary dosimetry metrics: volume CT dose index (CTDIvol measured in mGy) and dose-length product (DLP measured in mGy.cm).MethodsData from 19 CT scanners in seven institutions under one of Singapore healthcare cluster were retrospectively collected and analysed. The five common adult CT examinations analysed were CT Brain (non-contrast enhanced), CT Chest (IV contrast enhanced), CT Kidney-Ureter-Bladder (CT KUB, non-contrast enhanced), CT Pulmonary Angiogram (CT PA, IV contrast enhanced) and CT Abdomen-Pelvis (CT AP, IV contrast enhanced, single phase). Median CTDIvol and DLP values for the five CT examinations from each institution were derived, with the cluster DRLs determined as the 75th percentile of the distribution of the institution median dose values.ResultsA total of 2413 dose data points were collected over a six-month period from June to November 2020. The cluster CT DRLs for the five CT examinations were determined to be 47 mGy and 820 mGy.cm for CT Brain, 5.4 mGy and 225 mGy.cm for CT Chest, 6.7 mGy and 248 mGy.cm for CT PA, 4.6 mGy and 190 mGy.cm for CT KUB and 6.9 mGy and 349 mGy.cm for CT AP.ConclusionThe establishment of the cluster CT DRLs provided individual institutions with a better understanding if their CT doses are unusually high or low, while emphasising that these DRLs are not meant as hard dose limits or constraints to follow strictly. |
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| Keywords: | Diagnostic reference levels Diagnostic imaging Dose optimisation Patient safety Radiation dose Computed tomography |
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