Division of Medical Physics, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Division of Radiodiagnosis, Stellenbosch University, Cape Town, South Africa.
J Radiol Prot. 2021 Jun 1;41(2). doi: 10.1088/1361-6498/abfc98.
Diagnostic reference levels (DRLs) are accepted as a dose optimisation tool for patients undergoing x-ray imaging and are required by South African (SA) legislation for 26 fluoroscopically guided procedures (FGPs). The aim of this paper is to collate all published SA data on DRLs in preparation for a project to establish national DRLs. Systematic searches were conducted of various applicable databases. All research that proposed DRLs for any imaging procedure in South Africa was included. Twenty-one works met inclusion criteria, the earliest from 2001. Two-thirds of all work reported on FGPs and five studies documented computed tomography DRLs. Three publications focussed exclusively on paediatric imaging DRLs. No studies on mammography or dental radiography were found. For clinical procedures with more than one proposed DRL, the range of proposed DRL varied by up to a factor of five. The highest proposed DRL is 373.1 Gy cmfor endovascular aneurysm/aortic repair procedures. Data were collected in six public hospitals and two private hospital groups. Thirty-six authors contributed to the manuscripts, but only six studies had an inter-disciplinary authorship. This is the first paper to provide a comprehensive review of SA DRL data and thereby advances international radiation protection initiatives. The data suggests there is room for more interdisciplinary work and that there must be rigorous standardization of reported parameters and data collection. This audit also highlights the need for standardized terminology, particularly for FGPs.
诊断参考水平（DRLs）被认为是 X 射线成像患者的剂量优化工具，南非（SA）法规要求 26 项透视引导程序（FGPs）使用 DRLs。本文的目的是整理所有已发表的南非 DRL 数据，为建立国家 DRLs 项目做准备。系统地搜索了各种适用的数据库。所有为南非任何成像程序提出 DRL 的研究都包括在内。有 21 项工作符合纳入标准，最早的研究始于 2001 年。三分之二的工作报告了 FGPs，五项研究记录了 CT DRLs。有三篇出版物专门针对儿科成像 DRLs。未发现有关乳房 X 光检查或牙科射线照相的研究。对于有多个建议 DRL 的临床程序，建议的 DRL 范围相差高达五倍。建议的最高 DRL 是血管内动脉瘤/主动脉修复程序的 373.1 Gy cm。数据是在六家公立医院和两家私立医院集团中收集的。有 36 位作者为这些手稿做出了贡献，但只有六项研究有跨学科作者。这是第一份全面审查南非 DRL 数据的论文，从而推进了国际辐射防护计划。这些数据表明，有更多跨学科工作的空间，并且必须严格规范报告的参数和数据收集。这次审核还强调了标准化术语的必要性，特别是对于 FGPs。
