Establishment of local diagnostic reference levels for CT colonography at a tertiary hospital.

BACKGROUND

Diagnostic reference levels (DRLs) are an important metric in identifying abnormally high radiation doses in diagnostic examinations. National DRLs for CT colonography do not currently exist in South Africa, but there are efforts to collect data for a national DRL project.

OBJECTIVES

This study investigated radiation doses for CT colonography in adult patients at a large tertiary hospital in South Africa with the aim of setting local DRLs.

METHOD

Patient data from two CT scanners (Philips Ingenuity and Siemens Somatom go.Top) in the period March 2020 - March 2023 were obtained from the hospital's picture archiving and communication system (PACS) ( = 115). Analysis involved determining the median computed tomography dose index-volume (CTDI) and dose-length product (DLP) values. The findings were compared with DRLs established internationally.

RESULTS

Ingenuity median CTDI was 20 mGy and DLP was 2169 mGycm; Somatom median CTDI was 6 mGy and DLP was 557 mGycm. Ingenuity exceeded the United Kingdom's (UK) recommended DRLs by 82% and 214%, respectively. Somatom median CTDI and DLP were 45% and 19% lower than UK NDRLs.

CONCLUSION

Somatom's tin filter and other dose reduction features provided significant dose reduction. These data were used to set DRLs for CT colonography at the hospital; CTDI: 6 mGy and DLP: 557 mGy*cm.

CONTRIBUTION

In addition to informing radiation protection practices at the level of the institution, the established local DRLs contribute towards implementing regional and national DRLs.