The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Investigating CT head diagnostic reference levels based on indication-based protocols – a single site study
Open accessAbstract
INTRODUCTION: This study aimed to provide clinically-relevant insights into establishing CT DRLs based on indication-based protocols in Ireland, focusing on CT head examinations performed at a neurology centre of excellence hospital. METHODS: Dose data were collected retrospectively. Typical values for six CT head indication-based protocols were established using a sample size of 50 patients for each protocol. Typical values for each protocol were set as the median of the distribution curve. Dose distributions for each protocol were calculated and compared using non-parametric median test (k-samples) to ascertain significant dose differences between the typical values. RESULTS: Most typical values pairings showed significant differences (p < 0.001) except between stroke/non-vascular brain, stroke/acute brain, and acute brain/non-vascular brain pairings. This was expected due to similar scan parameters. The typical value for stroke (3-phases angiogram) was 52% lower than the typical value for stroke. Dose levels of the male populations recorded were higher than female populations for all protocols. Statistical comparison showed significant differences for dose quantities and/or scan length between both genders in five protocols. CONCLUSION: Proposed values for DLP were up to 63% and 69% lower than the EU and Irish national DRLs respectively. Establishment of CT stroke DRLs should be based on the scan performed instead of number of scan acquisitions. Lastly, gender-based CT DRLs for specific protocols within the head region require further investigation. IMPLICATIONS FOR PRACTICE: With increasing CT examinations worldwide, radiation dose optimisation is key. The value of indication based DRLs is to enhance the required patient protection so image quality can be maintained, however with relevant DRLs for varying protocols. Establishment of CT typical values and site specific DRLs for procedures beyond the national DRLs can drive dose optimisation locally.
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“This gap indicates not just discrepancies in patient demographics and equipment but also methodological disparities in data collecting and dosage analysis.116”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [116]
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ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging
Vañó, E., Miller, D. L., Martin, C. J., Rehani, M. M., Kang, K., Rosenstein, M., Ortiz-López, P., Mattsson, S., Padovani, R., & Rogers, A. (2017) · Annals of the ICRP · doi:10.1177/0146645317717209 · Cited by 1,043
Sample Size and its Importance in Research
Andrade, C. (2020) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_504_19 · Cited by 424
Smith‐Bindman, R., Wang, Y., Chu, P., Chung, R., Einstein, A. J., Balcombe, J. N., Cocker, M. R., Das, M., Delman, B. N., Flynn, M., et al. (2019) · BMJ · doi:10.1136/bmj.k4931 · Cited by 256
Treier, R., Aroua, A., Verdun, F. R., et al. (2010) · Radiation Protection Dosimetry · doi:10.1093/rpd/ncq279 · Cited by 143
Paulo, G., Damilakis, J. E., Tsapaki, V., et al. (2020) · Insights into Imaging · doi:10.1186/s13244-020-00899-y · Cited by 107
Tsapaki, V., Damilakis, J. E., Paulo, G., et al. (2021) · European Radiology · doi:10.1007/s00330-020-07652-5 · Cited by 85
Morin, R. L., Coombs, L. P., & Bhargavan, M. (2011) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2010.12.022 · Cited by 67
Geryes, B. H., Hornbeck, A., Jarrige, V., Pierrat, N., Pointe, H. D. L., & Dreuil, S. (2019) · Physica Medica · doi:10.1016/j.ejmp.2019.04.004 · Cited by 45
Inadequate Clinical Indications in Computed Tomography Chest and Abdomen/Pelvis Scans
Finger, A., Harris, M. H., Nishimura, E., & Yoon, H. (2018) · The Permanente Journal · doi:10.7812/tpp/18-017 · Cited by 4
Research works printed but not linked: 3
- International Commission of Radiological Protection, 1996, ICRP publication 73: radiological protection and safety in medicine, Ann ICRP, 26
- Health Service Executive, 2017, National survey on population dose from computed tomography, Med Exposure Radiat Unit
- Damilakis, 2018, Clinical diagnostic reference levels in medical imaging, Health Manag, 18, 402
Cited by
Oglat, A., Shdaifat, S., Sayah, M., Abukonna, A., & Khogali, W. (2026) · Drug, Healthcare and Patient Safety · doi:10.2147/dhps.s595721
Metadata
- Authors
- Tan, W. S., Foley, S., & Ryan, M. L.
- Affiliations
- University College Dublin (IE)
- Corresponding author
- Ryan, M.L.
- ORCID
- Venue
- Radiography
- Publisher
- Elsevier BV
- Published
- 2023-07
- Volume
- 29
- Issue
- 4
- Pages
- 786-791
- ISSN
- 1078-8174 (ISSN-L)
- OpenAlex
- W4378901051
- Cited by
- 15
- References
- 9
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 3
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Radiography (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- diagnostic reference levels, head CT, radiation dose optimization, dose-length product, stroke imaging, typical values, patient radiation protection
- MeSH terms
- Diagnostic Reference Levels, Female, Humans, Male, Radiation Dosage, Reference Values, Retrospective Studies, Tomography, X-Ray Computed, Stroke
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