Establishment of institutional diagnostic reference level for computed tomography with cloud-based digital dose-tracking software and computed tomography dose optimisation

The aim of this study is to identify the diagnostic reference levels (DRL) that are used as the reference value for the standardization and optimization of the radiation dose on computed tomography (CT) examinations. CT is one of the most important sources of ionizing radiation. The number of CT scans has increased dramatically in recent years. Dose optimization has become a critical issue with increasing radiation exposure. The DRL is well-established and has been widely accepted for many years. It is highly effective in decreasing radiation dose. DRL levels are published periodically in many countries. In our study, institutional DRL for CT were established for the first time in Turkey with cloud-based digital dose-tracking software. 8 CT scanners in 5 different radiology units in our institute were used. At the initial stage, CT scanners were calibrated and validated with phantom studies to eliminate the possible errors in the radiation dose measurements. In the second stage, data were collected by using a digital cloud-based software. Descriptive statistical analyses were performed. 25th, 50th and 75th percentiles of DLP, CTDIvol values were calculated according to examinations and CT scanners. At the same time, 75th percentile of the DLP and CTDIvol values obtained from each center were determined as the DRL value. Determination of the risk associated with radiation dose in CT, which is frequently used in medical imaging, will greatly contribute to the safer use of diagnostic decision support systems and will be an important step towards protecting the public health.