Towards the Establishment of National Diagnostic Reference Levels (DRLs) in Palestine: Assessment of Patient Doses in Common Adult CT Examinations in Governmental Health Sector

Abstract: CT-scan is the most irradiating tool in diagnostic radiology. Patient’s radiation protection must, therefore, be increased during CT-scan procedures. This requires a review and evaluation of the radiation dose in CT examinations. This study aims to assess the average doses, i.e. dose descriptors (CTDIvol and DLP)) in the West Bank- Palestinian governmental hospitals, for the most common adult computed tomography (CT) routine examinations. It compares its average doses and determines their variations from international assessments toward the adjustment of any improper dose level usage for the application of radiation m (ALARA) principle in our hospitals. The study applies a quantitative research method carried out on a representative sample, in which all the available data was taken from exams including (CTDIvol, DLP, other acquisition parameters).

Our study was carried out in all routine examinations (Brain, Chest, Abdominopelvic, and Lumbar spine examinations), which were performed in the West Bank imaging facilities, in a period of three months. The study concluded with the following results. About 2998 CT scan examinations were collected and distributed. In each type of examination, great variations in the average doses, i.e. doses descriptors, CTDIvol, and DLP, from the other countries averages were observed. Enormous variations were noticed in the comparison among the West Bank imaging facilities, found in all facilities and examinations, except the abdominopelvicin which relatively low variations were detected. All these variations are closely related to the type of examination, protocol that is applied in each facility, scanning parameters, and the acquisition parameter selections by the technologist. This form of studies may help the Ministry of Health in the establishment of National Dose reference levels. CT technologists should not use the same protocols and technical factors for all patients at each individual examination and should take training courses to develop their expertise. Other studies should be implemented on private hospitals