Zhang Zongrui,Kang Tianliang,Li Zhentao,et al.Exploration of radiation dose and diagnostic reference level for adult CT scans in Beijing[J].Chinese Journal of Radiological Medicine and Protection,2025,45(3):229-236
Exploration of radiation dose and diagnostic reference level for adult CT scans in Beijing
Received:April 17, 2024  
DOI:10.3760/cma.j.cn112271-20240417-00140
KeyWords:CT  Radiation dose  Diagnostic reference level  Achievable dose
FundProject:国家自然科学基金(82271988)
Author NameAffiliationE-mail
Zhang Zongrui Department of Radiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China  
Kang Tianliang Department of Radiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China  
Li Zhentao Department of Radiology, Peking University People's Hospital, Beijing 100044, China  
Zhang Yongxian Department of Radiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China  
Liu Dandan Department of Radiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China  
Qu Xiaoxia Department of Radiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China  
Niu Yantao Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China ytniu163@163.com 
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Abstract::
      Objective To investigate the status and diagnostic reference levels (DRLs) of adult CT radiation dose based on survey result from some hospitals in Beijing. Methods From September to December 2023, the survey results for 50 hospitals were collected in Beijing, including 47 tertiary hospitals and 3 second grade general hospitals. The CT data sets in total of 20 items including head (sequential scanning), head (spiral scanning), head perfusion, sinus, neck, chest, chest (low dose scanning), abdomen, pelvis, abdomen-pelvis, chest-abdomen-pelvis, lumbar spine, CT urography, coronary CTA (retrospective), coronary CTA (prospective), head CTA, neck CTA, aorta CTA, leg CTA and knee were collected on clinical commonly used CT scanners with annual qualified state inspection. For each item, radiation dose data was collected continuously and randomly for up to 50 cases for every CT scanner. Using the volume CT dose index (CTDIvol) and dose length product (DLP) as dose parameters, the median value of each item in each hospital was obtained. The median CTDIvol and DLP values of all hospitals were arranged, and the local DRL of each item was set as the 75th percentile of the median values. The obtained DRLs were compared with the DRLs issued by domestic and international radiological protection organizations. Results A total of 26 031 dose values of adult patients were collected and 25 996 dose values were left while 35 invalid values removed.For different CT users, CTDlvol, DLP and scanning phases were different for the same item. The five items with the highest CTDI were head perfusion, head sequential scanning, head spiral scanning, coronary CTA (retrospective mode), and sinus. The five items with the highest DLP were CTU, head perfusion, leg CTA, chest-abdomen-pelvis and aortic CTA. The CTDIvol of CTU was only 16.9 mGy (75th percentile), while the DLP was as high as 2 394.9 mGy·cm (75th percentile). The survey showed that the DRLs of most items in Beijing was lower than the national DRLs of domestic and foreign standards, and the DRLs of a small number of items were slightly higher. Conclusion The current CT dose level in Beijing is not consistent with national DRLs released at home and abroad, so it is necessary to establish local DRLs according to the clinical status in Beijing.
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