The growing potential of diagnostic reference levels as a dynamic tool for dose optimization

Published:March 20, 2021DOI:


      • DRLs should be a dynamic tool that follows the development of clinical practice.
      • A standardised approach is needed to facilitate the establishment and use of DRLs.
      • Dose monitoring systems can improve the cycle of establishing, updating and using DRLs.


      Diagnostic Reference Levels (DRLs) is an important tool that can improve radiation safety in medical imaging. However, there are certain aspects that need improvement and several obstacles that should be overcome before DRLs are fully implemented in practice. It is the authors belief that DRLs should be a dynamic tool that follows the development of clinical practice and technology advances. The establishment of adult and paediatric DRLs based on clinical indications should be considered as a priority. A common methodology and terminology is needed to allow for their clinical use. Dose monitoring systems can improve and accelerate the establishment, update and use of DRLs. However, certain steps need to be taken for proper collection. organization and analysis of big data. Availability of clinically qualified medical physicists in medical imaging departments, awareness on the importance of dose optimization and proper cooperation of relevant stakeholders are important prerequisites for the successful establishment and use of DRLs.
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