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National and local diagnostic reference levels for adult 18F-FDG and CT in Jordanian PET/CT: findings and implications in practice
Abstract
This study aims to report the findings of Jordanian national diagnostic reference level (NDRL) survey for fluorodeoxyglucose (18 F-FDG) and local diagnostic reference level (LDRL) of computed tomography (CT) used for attenuation correction and anatomical localisation (AC-AL); and AC and diagnostic CT (AC-DX) within the context of whole-body WB and half-body HB adult oncology PET/CT scanning. Two-structured questionnaires were prepared to gather the necessary information: dosimetry data, patient demographics, equipment specification, and acquisition protocols for identified 18 F-FDG PET/CT procedures. The NDRL and achievable dose were reported based on the 75th and 50th percentiles for 18 F-FDG administered activity (AA), respectively. The LDRL was reported based on the 50th percentile for (CTDI vol) and (DLP). Data from 562 patients from four Jordanian PET/CT centres were collected. The survey revealed that Jordanian NDRL for AA (303 MBq) was within the acceptable range compared to the published-peer NDRL data (240–590 MBq). However, the 18 F-FDG AA varied across the participated PET/CT centres. The reported LDRL CTDI vol and DLP of CT used for (AC-AL) was 4.3 mGy and 459.3 mGy.cm for HB CT scan range, and 4.1 mGy and 659.9 mGy.cm for WB CT scans. The reported LDRL for CTDI vol and DLP for HB CT was higher when compared with the United Kingdom (3.2 mGy and 310 mGy.cm). Concurrently, in the context of WB CT, the reported values (i.e. CTDIvol and DLP) were also higher than both Kuwait (3.6 mGy and 659 mGy.cm) and Slovenia (3.6 mGy and 676 mGy.cm). The reported HB CT(AC-DX) was higher than Nordic, New Zealand and Swiss NDRLs and for WB (AC-DX) CT it was higher than Swiss NDRLs. This study reported the first Jordanian NDRL for 18 F-FDG and LDRL for HB and WB CT associated with 18 F-FDG PET/CT scans. This data is useful for Jordanian PET/CT centres to compare their LDRL to the suggested DRLs and utilise it in the process of optimising CT radiation doses.
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“In Jordan, an increasing emphasis on radiation protection and quality assurance in medical imaging has initiated endeavors to create and revise national CT diagnostic reference levels (DRLs).6–8”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [8]
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Cited by
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Metadata
- Authors
- Alhorani, Q., Alkhybari, E., Rawashdeh, M., Sabarudin, A., Latiff, R. A., Al-Ibraheem, A., & Mohamad, M.
- Affiliations
- Prince Sattam Bin Abdulaziz University (SA)
- Jordan University of Science and Technology (JO)
- National University of Malaysia (MY)
- ORCID
- Venue
- Journal of Radiological Protection
- Publisher
- IOP Publishing
- Published
- 2024-03-01
- Volume
- 44
- Issue
- 1
- Pages
- 011512
- ISSN
- 0952-4746 (ISSN-L)
- 1361-6498
- OpenAlex
- W4392087464
- Cited by
- 6
- References
- 36
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Radiological Protection (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- diagnostic reference levels, 18F-FDG PET/CT, CT radiation dose, radiation dose, attenuation correction, whole-body CT, CTDIvol, dose-length product, Jordan, tumor imaging, radiation protection, CT acquisition protocols
- MeSH terms
- Positron Emission Tomography Computed Tomography, Diagnostic Reference Levels, Adult, Humans, Jordan, Radiation Dosage, Reference Values, Tomography, X-Ray Computed, Fluorodeoxyglucose F18
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