Adult national diagnostic reference levels for common computed tomography examinations in Zambia: A preliminary study with findings from public hospitals

IF 2.8 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiography Pub Date : 2025-03-26 DOI:10.1016/j.radi.2025.102925

S. Kafwimbi , J.M. Sichone , F. Munsanje , O. Sutherland , O. Bwanga , B. Ohene-Botwe , S.M. Munsaka

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Abstract

Introduction

While many European and American countries have established national diagnostic reference levels (NDRLs), few African countries have. Therefore, this study aimed to propose adult NDRLs for common computed tomography (CT) examinations in Zambia.

Methods

1360 CT patient data for the brain, chest, abdomen and pelvis were collected from 10 public CT facilities. The CT images were assessed for acceptable image quality and patient anthropometry was done, with patients' anteroposterior diameter used as the patient parameter. NDRLs were set at the 75th percentile of the distribution of volume-based CT dose index (CTDI_vol) and dose length product (DLP) and were compared to countries’ NDRLs.

Results

NDRLs for CTDI_vol in mGy were calculated as follows; non-contrast brain 70.5, contrast brain 56.74, non-contrast chest 20.24, contrast chest 20, non-contrast abdomen/pelvis, 21.3, contrast abdomen/pelvic 21.3, non-contrast chest/abdomen/pelvis 20 and contrast chest/abdomen/pelvis 19.1. The corresponding NDRLs for DLP in mGy.cm are 1455, 1206, 745.8, DLP 666.7, 1103, 1103, 1237 and 1141. Variations in DLP values between facilities were statistically significant (p < 0.0001). NDRLs for the brain and chest were higher than those from other countries but lower for the abdomen/pelvis and chest/abdomen/pelvis. Correlations between the CT scanner's number of detector rows and CTDI_vol were (r = 0.08285, p < 0.0.0022) and (r = 0.5038, p < 0.0001) between patients' AP diameter and CTDI_vol.

Conclusion

The proposed NDRLs confirmed the need to optimise CT scan parameters and protocols in Zambia. Therefore, extensive training of all CT radiographers in optimising CT image acquisition parameters and regular dose audits is recommended.

Implication of practice

NDRLs will likely provide a benchmarking mechanism for dose optimisation practices among CT radiographers in Zambia and beyond.

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赞比亚成人普通计算机断层扫描检查的国家诊断参考水平：来自公立医院的初步研究结果

虽然许多欧美国家已经建立了国家诊断参考水平（ndrl），但非洲国家却很少。因此，本研究旨在建议赞比亚成人ndrl进行普通计算机断层扫描（CT）检查。方法收集10家公共CT机构1360例脑、胸、腹、骨盆CT资料。评估CT图像的可接受图像质量，并对患者进行人体测量，以患者的前后径作为患者参数。NDRLs设定在基于体积的CT剂量指数（CTDIvol）和剂量长度积（DLP）分布的第75百分位，并与各国的NDRLs进行比较。结果CTDIvol在mGy组的sndrls计算如下：脑对比70.5，脑对比56.74，胸对比20.24，胸对比20，腹/盆对比21.3，腹/盆对比21.3，胸/腹/盆对比20，胸/腹/盆对比19.1。mGy中DLP对应的NDRLs。尺寸为1455、1206、745.8，DLP为666.7、1103、1103、1237和1141。不同设施间DLP值的差异具有统计学意义(p <；0.0001)。脑和胸部的NDRLs高于其他国家，但腹部/骨盆和胸部/腹部/骨盆的NDRLs低于其他国家。CT扫描仪的检测器行数与CTDIvol的相关性为(r = 0.08285, p <；0.0.0022)和(r = 0.5038, p <；0.0001)，患者AP直径与CTDIvol之间存在差异。结论提出的NDRLs证实了赞比亚需要优化CT扫描参数和方案。因此，建议对所有CT放射技师进行广泛的培训，以优化CT图像采集参数和定期剂量审计。实践的意义drl可能会为赞比亚和其他国家的CT放射技师提供剂量优化实践的基准机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.