A Review Study on National Diagnostic Reference Levels for Computed Tomography Examinations

국내·외 전산화단층촬영 진단참고준위 설정 현황 리뷰

  • Kim, Jong Hwa (Department of Nuclear Engineering, Kyung Hee University) ;
  • Kim, Woo Jin (Department of Nuclear Engineering, Kyung Hee University) ;
  • Lee, Min Young (Department of Nuclear Engineering, Kyung Hee University) ;
  • Park, Il (Department of Nuclear Engineering, Kyung Hee University) ;
  • Lee, Bo Haeng (Department of Nuclear Engineering, Kyung Hee University) ;
  • Kim, Kwang Pyo (Department of Nuclear Engineering, Kyung Hee University)
  • 김종화 (경희대학교 원자력공학과) ;
  • 김우진 (경희대학교 원자력공학과) ;
  • 이민영 (경희대학교 원자력공학과) ;
  • 박일 (경희대학교 원자력공학과) ;
  • 이보행 (경희대학교 원자력공학과) ;
  • 김광표 (경희대학교 원자력공학과)
  • Received : 2018.10.11
  • Accepted : 2018.12.13
  • Published : 2018.12.31

Abstract

The use of CT examinations is increasing rapidly and radiation dose from CT examinations is much higher than other diagnostic radiography examinations including general radiography and mammography. DRLs used to optimize the radiation dose of patients by diagnostic radiology in each country. The objective of this study was to investigate and to analyze the status of DRLs from CT examinations in domestic and other countries. In other countries, DRLs were set for each age group and each examination considering the medical situation of each country. In Korea, DRLs were set for adults and children in 2017. For adults, DRLs were set for 13 examinations. Reported DLP values were 1119, 297, $472mGy{\cdot}cm$ for head, chest and abdomen pelvis examination, respectively. For children, DRLs were set for head examinations. Reported DLP values were 298 (0~1 years), 404 (2~5 years), 494 (6~10 years), 1,088 (11~15 years) $mGy{\cdot}cm$. DRLs of Korea were similar to other countries for head examinations. For chest examinations and abdomen pelvis examinations were relatively lower than other countries. As a major reason for relatively low radiation dose, it is considered to contribute the activity and management of medical radiation safety at national level.

Keywords

Acknowledgement

Supported by : 한국원자력안전재단

References

  1. 식품의약품안전청. 2008. 의료방사선 이용에 따른 국민방사선량 평가 연구.
  2. 질병관리본부. 2017. 의료방사선 이용에 따른 국민방사선량 평가 연구.
  3. 질병관리본부. 2017. 전산화단층촬영에서의 진단참고수준 가이드라인. 의료방사선 시리즈 No. 10.
  4. ACR. 2013. ACR-AAPM Practice Guideline for Diagnostic Reference Levels and Achievable Doses in Medial X-ray Imaging. ACR Practice Guideline. American College of Radiology. ACR-AAPM Resolution 47.
  5. BfS. 2003. Bekanntmachung der diagnostischen Referenzwerte fur radiologische und nuklearmedizinische Untersuchungen vom 22.
  6. BfS. 2010. Diagnostische Referenzwerte fur diagnostische und interventionelle Rontgenanwendungen.
  7. BfS. 2016. Bekanntmachung der aktualisierten diagnostischen Referenzwerte fur diagnostische und interventionelle Roontgenanwendungen.
  8. CRCPD. 1990. Nationwide evaluation of x-ray trends (NEXT): Evaluation of past impact, current status, and future plans. Frankfort, KY: Conference of Radiation Control Program Directors. CRCPD Publication 90-5.
  9. EC. 1998. Implementation of the Medical Exposure Directive. Luxembourg: European Commission. EC Radiation Protection Report 102.
  10. EC. 1999. European Guidelines Quality Criteria for Computed Tomography, European Guidelines. Luxembourg: Commission of the European Communities. EUR 16262.
  11. EC. 2008. European Guidance on Estimating Population Doses from Medical X-Ray Procedures. Luxembourg: European Commission. EC Radiation Protection Report 154.
  12. EC. 2014. Diagnostic Reference Levels in Thirty-six European Countries. Luxembourg: European Commission. EC Radiation Protection Report 180 part 2.
  13. Galanski M, Nagel HD and Stamm G. 2006. Paediatric CT Exposure Practice in the Federal Republic of Germany. Medizinische Hochschule Hannover, Hannover.
  14. HPA. 2012. Doses to patients from radiographic and fluoroscopic x-ray imaging procedures in the UK - 2010 Review. HPACRCE-034, London.
  15. IAEA. 1996. International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. IAEA Safety Series No. 115, Vienna.
  16. ICRP. 1990. 1990 Recommendations of the international Commission on Radiological Protection. ICRP Publication 60. Ann. ICRP 21(1-3).
  17. ICRP. 1996. Radiological Protection and Safety in Medicine. ICRP Publication 73. Ann. ICRP 26(2).
  18. ICRP. 2000. Managing Patient Dose in Computed Tomography. ICRP Publication 87. Ann. ICRP 30(4).
  19. ICRP. 2017. Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann. ICRP 46(1).
  20. IEC. 1999. Medical Electrical Equipment Part 2: Particular Requirements for the Safety of X-Ray Equipment for Computed Tomography. Geneva, Switzerland. IEC 60601-2-44.
  21. J-RIME. 2015. Diagnostic Reference Levels Based on Latest Surveys in Japan.
  22. Kanal KM, Butler PF, Sengupta D, Bhargavan-Chatfield M, Coombs LP and Morin RL. 2017. U.S. diagnostic reference levels and achievable doses for 10 adult CT examinations. Radiology. 284:120-133. https://doi.org/10.1148/radiol.2017161911
  23. McCollough C, Branham T, Herlihy V, Bhargavan M, Robbins L, Bush K, McNitt-Gray M, Payne JT, Ruckdeschel T, Pfeiffer D, Cody D and Zeman R. 2011. Diagnostic reference levels from the ACR CT Accreditation Program. J. Am. Coll. Radiol. 8(11):795-803. https://doi.org/10.1016/j.jacr.2011.03.014
  24. NCRP. 2013. Reference Levels and Achievable Doses in Medical and Dental Imaging: Recommendations for the United States. NCRP Report No. 172.
  25. NRPB. 2005. National Radiological Protection Board. Doses from Computed Tomography (CT) examinations in the UK - 2003 review. NRPB-W67.
  26. PHE. 2014. Doses from Computed Tomography (CT) Examinations in the UK - 2011 Review: 2010 review. PHE-CRCE-013.
  27. UNSCEAR. 2010. Sources and effects of ionizing radiation. UNSCEAR 2008 Report to the General Assembly with Scientific Annexes. United Nations Publication Sales No. E. 10.XI.3. New York.