The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Diagnostic Reference Levels of Radiographic and CT Examinations in Jordan: A Systematic Review
Abstract
A comprehensive search was performed to examine the literature on diagnostic reference levels (DRL) for computed tomography (CT) and radiography examinations that are performed routinely in Jordan. EBSCO, Scopus, and Web of Science were used for the search. The acronym “DRL” and the additional phrase “dose reference levels” were used to search for articles in literature. Seven papers that reported DRL values for radiography and CT scans in Jordan were identified. One study reported DRLs for conventional radiography, two studies reported CT DRLs in pediatrics, and the remaining four studies provided DRL values for adult CT scans. The most popular techniques for determining the DRLs were the entrance surface dose, volume CT dose index (CTDI vol ), and dose-length product (DLP) values. Variations in Jordanian DRL values were noted across both modalities. Lower radiation doses and less variation in DRL values may be achieved by educating and training radiographers to better understand dose reduction strategies. To limit dose variance and enable dosage comparison, CT DRLs must be standardized in accordance with the guidelines of the International Commission on Radiological Protection (ICRP).
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Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The research emphasized methodological discrepancies, insufficient consistent reporting, and a scarcity of national DRL data.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“Alzyoud, Kholoud et al conducted a study to aggregate and assess available data on diagnostic reference levels (DRLs) for conventional radiography and computed tomography (CT) in Jordan.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“These investigations employed multiple dose metrics, including entrance surface dose (ESD), effective dose (ED), volume CT dose index (CTDI_vol), dose-length product (DLP), and, in one pediatric research, size-specific dose estimate (SSDE).”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“The results indicated considerable variability in diagnostic reference levels (DRLs), with adult chest radiography entrance surface doses (ESDs) spanning from 0.35 to 0.49 mGy and abdomen ESDs fluctuating significantly between 2.2 and 12.9 mGy.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“A comprehensive search of major databases until June 2023, adhering to PRISMA principles, discovered seven suitable studies: one concerning conventional radiography, two pertaining to pediatric CT, and four related to adult CT examinations.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“In comparison to international benchmarks, Jordanian radiography diagnostic reference levels (DRLs) were frequently elevated, although pediatric CT volume CTDI values were similar, but dose-length products (DLPs) generally beyond global standards.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“CT diagnostic reference levels (DRLs) were specified by anatomical area and age cohort, with adult chest CTDI_vol ranging from 12.9 to 16.6 mGy, with CAP examinations exhibiting DLPs as elevated as 1,150 mGy·cm.9”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
In the citing paper
“Pediatric dosages were often smaller but escalated with age.”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [9]
Citations
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283
International Atomic Energy Agency
(2022) · Permanent missions to the United Nations · doi:10.18356/9789210018289c237 · Cited by 3,884
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
American Association of Physicists in Medicine
(1973) · Radiology · doi:10.1148/106.3.717b · Cited by 731
Size-Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations
Boone, J. M., Strauss, K. J., CODY, D. D., et al. (2011) · doi:10.37206/143 · Cited by 554
CT Dose Index and Patient Dose: They AreNotthe Same Thing
McCollough, C. H., Leng, S., Yu, L., CODY, D. D., Boone, J. M., & McNitt‐Gray, M. F. (2011) · Radiology · doi:10.1148/radiol.11101800 · Cited by 463
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Size-specific Dose Estimates for Adult Patients at CT of the Torso
Christner, J. A., Braun, N. N., Jacobsen, M. C., Carter, R. E., Kofler, J. M., & McCollough, C. H. (2012) · Radiology · doi:10.1148/radiol.12112365 · Cited by 188
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Doses to patients from routine diagnostic X-ray examinations in England
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Research works printed but not linked: 2
- 2008, European guidance on estimating population doses from medical x-ray procedures, Radiat Protect, 154, 90
- 1998, Pediatric effective doses in diagnostic radiology, In: 44th annual scientific meeting of Canadian Organization of Medical Physicists; London, Ontario, Canada[online], 114
Cited by
Sorted by citations
Oglat, A., Shdaifat, S., Sayah, M., Abukonna, A., & Khogali, W. (2026) · Drug, Healthcare and Patient Safety · doi:10.2147/dhps.s595721
“9,10 The review aims to enhance radiation protection standards in Jordan and promote the advancement of safe imaging procedures by examining commonalities, discrepancies, and opportunities for improvement.”
Metadata
- Authors
- Alzyoud, K., Al-Murshedi, S., & England, A.
- Affiliations
- Hashemite University (JO)
- AL-Zahraa University for Women, College of Health and Medical Technology, Karbala, Iraq
- University College Cork (IE)
- Corresponding author
- Alzyoud, Kholoud
- Venue
- Health Physics
- Published
- 2024-03
- Volume
- 126
- Issue
- 3
- Pages
- 156-162
- ISSN
- 0017-9078 (ISSN-L)
- 1538-5159
- OpenAlex
- W4391123206
- Cited by
- 6
- References
- 24
- Citations by year
- 2026: 2 · 2025: 4
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Physics (publishedVersion)
- PubMed (publishedVersion)
- Cork Open Research Archive (University College Cork, Ireland) (submittedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Keywords
- diagnostic reference levels, radiation dose, computed tomography, radiography, Jordan, pediatric CT, entrance surface dose, volume CT dose index, dose-length product, dose reduction strategies, dose standardization
- MeSH terms
- Diagnostic Reference Levels, Adult, Child, Humans, Jordan, Radiation Protection, Tomography, X-Ray Computed
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