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National indication-based diagnostic reference level values in computed tomography: Preliminary results from Ghana

  • Benard Ohene Botwe
    Correspondence
    Corresponding author at: Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana.
    Affiliations
    Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana

    Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Legon, Ghana
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  • Cyril Schandorf
    Affiliations
    Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Legon, Ghana
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  • Stephen Inkoom
    Affiliations
    Medical Physics Department, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Ghana

    Radiation Protection Institute (RPI), Ghana Atomic Energy Commission, Accra, Ghana
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  • Augustine Faanu
    Affiliations
    Radiological and Non-ionizing Radiation Directorate, Nuclear Regulatory Authority, Accra, Ghana
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  • Linn Rolstadaas
    Affiliations
    Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
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  • Pål Erik Goa
    Affiliations
    Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway

    Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
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Published:March 25, 2021DOI:https://doi.org/10.1016/j.ejmp.2021.03.012

      Highlights

      • In Ghana there are no established national indication-based diagnostic reference levels.
      • First national indication-based diagnostic reference levels have been developed.
      • The developed diagnostic reference levels are recommended to be used to manage dose in Ghana.

      Abstract

      Purpose

      This study was conducted to develop national indication-based DRL values for common indications of adult computed tomography (CT) examinations for clinical application in Ghana.

      Materials and methods

      The methodological approach recommended by the International Commission on Radiological Protection (ICRP), Publication 135, for the development of DRLs, was employed. Studies on CT infrastructure, common indications and quality control tests were first undertaken. A sample of 20 CT dose descriptor/quantity data sets were collected from each centre for each indication. Overall, 3960 data sets were collected for all identified common indications from 71.4% of the total CT scanners in Ghana (25/35). The data were collected from image folders reported and accepted by radiologists. The objective image quality was assessed through a signal to noise ratio (SNR) analysis prior to using the data and extracting DRL values.

      Results

      Clinical indications and their respective DRL values in terms of volume weighted CT dose index (CTDIvol) and dose length product (DLP) were cerebrovascular accident (CVA)/stroke (77 mGy; 1313 mGy.cm), head trauma/injury (76 mGy; 1596 mGy.cm), brain tumour/space occupying lesion (SOL) (77 mGy; 2696 mGy.cm), lung tumour/cancer (12 mGy; 828 mGy.cm) and chest lesion with chronic kidney disease (CKD) (13 mGy; 467 mGy.cm). Others were abdominopelvic lesion (17 mGy; 1299 mGy.cm), kidney stones (15 mGy; 731 mGy.cm), urothelial malignancy/CT-intravenous urogram (CT-IVU) (11 mGy; 1449 mGy.cm) and pulmonary embolism (PE) (14 mGy; 942 mGy.cm).

      Conclusion

      National Indication-based DRL values developed in this study are recommended to be used to manage CT radiation dose in Ghana.

      Keywords

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