2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu
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| date | 2023-06-28 |
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| id | 15828 |
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| internalnotes | Sila masukkan subject wajib Dissertations, Academic. Terima kasih... |
| originalfilename | 15828_f2c3413c5b98b10.pdf |
| person | Irwan Iskandar Bin Jusoh |
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| spelling | 15828 https://intelek.unisza.edu.my/intelek/pages/view.php?ref=15828 https://intelek.unisza.edu.my/intelek/pages/search.php?search=!collection3 General Document Malaysia Library Staff (Top Management) Library Staff (Management) Library Staff (Support) Terengganu Faculty of Health Sciences English application/pdf 1.5 149 Server storage Scanned document Universiti Sultan Zainal Abidin UniSZA Private Access UNIVERSITI SULTAN ZAINAL ABIDIN SAMBox 2.4.24; modified using iTextSharp™ 5.5.10 ©2000-2016 iText Group NV (AGPL-version) Copyright©PWB2025 15828_f2c3413c5b98b10.pdf 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu Irwan Iskandar Bin Jusoh 2023-06-28 Computed tomography—Radiation dosage Computed Tomography (CT) is one of the imaging techniques capable of producing high-resolution images to diagnose diseases. However, CT has the disadvantage of a high radiation dose that can cause the risk to develop cancer. The International Commission on Radiological Protection (ICRP) has introduced Diagnostic Reference Level (DRLs) to highlight the need for enhancing patient protection. The current Malaysian DRLs values are based on data collected in 2013. Therefore, updating the DRLs should be conducted in line with the development of CT scanner technology. ICRP recommends developing DRLs based on local data to improve the current dose levels received by patients. The aim of this study was to determine the current radiation dose and establish local DRLs for common CT examinations in Terengganu, Malaysia. A structured booklet survey was developed and distributed to each hospital or site. Data were collected from September to November 2020 based on the period with the highest frequency of patients undergoing CT examinations. Measurements using two main dose metrics namely dose length product (DLP) and CT dose index volume (CTDIvol), as well as two elective dose metrics namely size specific dose estimate (SSDE) and effective dose ED were performed. The 50th and 75th percentile values were used to calculate the local DRLs for each site and were compared with the National DRLs (NDRLs). Additionally, the correlation between several CT scan parameters and dose metric values was also investigated. A total of 329 CT examinations of the head, thorax, and abdomen were recorded from Hospital Sultanah Nur Zahirah (HSNZ), Hospital Kemaman (HK) dan Kuala Terengganu Specialist (KTS) that have CT scanners in Terengganu. This study found that for CT head, CTDIvol of sites 1 and 2 showed higher dose values than NDRLs but site 3 showed the lowest dose values. However, the DLP of all sites showed lower dose values than the NDRLs. For CT thorax, only CTDIvol of site 1 showed higher dose values than NDRLs. Accordingly, DLPs of all sites showed a similar pattern to CTDIvol compared to NDRLs. For CT abdomen, CTDIvol and DLP of all sites showed higher dose values than NDRLs with sites 1 and 3 showing an almost threefold difference. However, CTDIvol site 2 showed slightly lower dose values than NDRLs. The SSDE value for CT head showed the highest value (50.82±12.1 mGy) as compared to CT thorax and abdomen with 31.05±31.0 mGy and 31.28±23.8 mGy respectively. The ED for CT head was the lowest (2.0±1.6 mSv) with CT thorax and abdomen being 8.0±4.3 mSv and 12.6±8.1 mSv respectively. All scan parameters for CT head, tube voltage and scan length for CT thorax, and tube current and tube voltage for CT abdomen showed significant correlations (p<0.05) to dose metric values. The proposed local DRLs for CT of the head and thorax are up to 12% lower than the current NDRLs. However, an increase in median DLP for CT abdomen was also found compared to the 75th percentile of NDRLs. Therefore, there is a need for optimisation on current practices. Dissertations, Academic Sila masukkan subject wajib Dissertations, Academic. Terima kasih... Computed Tomography Dose Optimization Diagnostic Reference Levels (DRLs) in CT scans Radiation Exposure in Medical Imaging Thesis |
| spellingShingle | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| state | Terengganu |
| subject | Computed tomography—Radiation dosage Dissertations, Academic |
| summary | Computed Tomography (CT) is one of the imaging techniques capable of producing high-resolution images to diagnose diseases. However, CT has the disadvantage of a high radiation dose that can cause the risk to develop cancer. The International Commission on Radiological Protection (ICRP) has introduced Diagnostic Reference Level (DRLs) to highlight the need for enhancing patient protection. The current Malaysian DRLs values are based on data collected in 2013. Therefore, updating the DRLs should be conducted in line with the development of CT scanner technology. ICRP recommends developing DRLs based on local data to improve the current dose levels received by patients. The aim of this study was to determine the current radiation dose and establish local DRLs for common CT examinations in Terengganu, Malaysia. A structured booklet survey was developed and distributed to each hospital or site. Data were collected from September to November 2020 based on the period with the highest frequency of patients undergoing CT examinations. Measurements using two main dose metrics namely dose length product (DLP) and CT dose index volume (CTDIvol), as well as two elective dose metrics namely size specific dose estimate (SSDE) and effective dose ED were performed. The 50th and 75th percentile values were used to calculate the local DRLs for each site and were compared with the National DRLs (NDRLs). Additionally, the correlation between several CT scan parameters and dose metric values was also investigated. A total of 329 CT examinations of the head, thorax, and abdomen were recorded from Hospital Sultanah Nur Zahirah (HSNZ), Hospital Kemaman (HK) dan Kuala Terengganu Specialist (KTS) that have CT scanners in Terengganu. This study found that for CT head, CTDIvol of sites 1 and 2 showed higher dose values than NDRLs but site 3 showed the lowest dose values. However, the DLP of all sites showed lower dose values than the NDRLs. For CT thorax, only CTDIvol of site 1 showed higher dose values than NDRLs. Accordingly, DLPs of all sites showed a similar pattern to CTDIvol compared to NDRLs. For CT abdomen, CTDIvol and DLP of all sites showed higher dose values than NDRLs with sites 1 and 3 showing an almost threefold difference. However, CTDIvol site 2 showed slightly lower dose values than NDRLs. The SSDE value for CT head showed the highest value (50.82±12.1 mGy) as compared to CT thorax and abdomen with 31.05±31.0 mGy and 31.28±23.8 mGy respectively. The ED for CT head was the lowest (2.0±1.6 mSv) with CT thorax and abdomen being 8.0±4.3 mSv and 12.6±8.1 mSv respectively. All scan parameters for CT head, tube voltage and scan length for CT thorax, and tube current and tube voltage for CT abdomen showed significant correlations (p<0.05) to dose metric values. The proposed local DRLs for CT of the head and thorax are up to 12% lower than the current NDRLs. However, an increase in median DLP for CT abdomen was also found compared to the 75th percentile of NDRLs. Therefore, there is a need for optimisation on current practices. |
| title | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| title_full | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| title_fullStr | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| title_full_unstemmed | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| title_short | 2023_Establishing Local Diagnostic Reference Levels for Computed Tomography of the Head, Thorax, and Abdomen in Selected Hospitals in Terengganu |
| title_sort | 2023_establishing local diagnostic reference levels for computed tomography of the head, thorax, and abdomen in selected hospitals in terengganu |