Establishment of Local Diagnostic Reference Levels for Head CT Imaging in the Madina Region, Saudi Arabia
Open accessAbstract
Background: Computed Tomography (CT) is crucial in medical diagnosis, particularly for head examinations. Diagnostic Reference Levels (DRLs) are pivotal in balancing diagnostic efficacy with radiation safety. International organizations such as the International Atomic Energy Agency (IAEA) and the International Commission on Radiological Protection (ICRP) provide guidelines for establishing DRLs, emphasizing their importance in optimizing radiation doses. Aim: This study aimed to establish and standardize DRLs for head CT imaging in institutional and regional settings, emphasizing the need for tailored reference levels specific to each region’s practices and standards. Method: Data collection included patient demographics, imaging parameters, and radiation dose indices, namely volume-weighted CT dose index (CTDIvol) and dose-length product (DLP). Statistical analyses were conducted to determine the median and 3rd quartile values for establishing DRLs. The results were compared with national and international benchmarks to assess variations in radiation doses across regions. Results: Demographic profiles detailed gender distributions and ages across hospitals. Imaging parameters exhibited variability in tube voltage, milliampere-seconds (mAs), pitch, scan length, and field of view (FOV). For CTDIvol, the 3rd quartile value was 65.8 mGy (range: 24.8–85.9 mGy), and for DLP, it was 1230.95 mGy·cm (range: 382.3–1189.0 mGy·cm). These values were slightly higher than the national DRLs for Saudi Arabia in 2021 and other international benchmarks, underscoring the need for further optimization and alignment of protocols. Conclusion: Optimizing and standardizing DRLs for head CT imaging is crucial for effectively managing radiation doses while ensuring diagnostic accuracy. Comparison with national and international benchmarks highlighted the importance of tailoring reference levels to regional practices and standards, ensuring patient safety without compromising diagnostic efficacy.
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A DRL is computed as the 75th percentile of the distribution of median dosages among facilities.
“Upon the accumulation of adequate data, the 75th percentile (third quartile) of the distribution of median dosages among facilities is computed.78”
From Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction (2026) · cites this paper as [78]
The Introduction (page unavailable) says DRLs are typically set at the 75th percentile of doses observed in a large sample of patients. Section 3.5 (page unavailable) discusses hospital median doses, but does not say to calculate the 75th percentile of those medians across facilities. The claim combines two elements the paper describes separately. (LLM, conf=0.86)
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Cites
Benefits and costs, an eternal balance
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ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging
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Self-citationEstablishing diagnostic reference levels for CT examinations in the south region of Saudi Arabia
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Self-citationDiagnostic Reference Levels: A Review
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DIAGNOSTIC REFERENCE LEVELS OF RADIOGRAPHIC AND CT EXAMINATIONS IN SAUDI ARABIA: A SYSTEMATIC REVIEW
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Establishment of Computed Tomography Diagnostic Reference Levels in Tobruk
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Oglat, A., Shdaifat, S., Sayah, M., Abukonna, A., & Khogali, W. (2026) · Drug, Healthcare and Patient Safety · doi:10.2147/dhps.s595721
- Authors
- Alhujaili, S. F., Alshabibi, A. S., Alafer, F., Alrowaili, Z., Salah, H., Sulieman, A., Subahi, M., Al-Raddadi, K., & Abuzaid, M.
- Affiliations
- Jouf University (SA)
- King Saud University (SA)
- Nuclear Medicine Department, Inaya Medical College, Riyadh 13541, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences (SA)
- Ministry of Health (SA)
- University of Sharjah (AE)
- Corresponding author
- Abuzaid, Mohamed
- ORCID
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2024-12-21
- Volume
- 14
- Issue
- 24
- Pages
- 2882
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC11675420
- OpenAlex
- W4405699577
- Cited by
- 7
- References
- 18
- Citations by year
- 2026: 6 · 2025: 1
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- 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, patient radiation protection
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