The establishment of Diagnostic Reference Levels for Diagnostic radiology at Chulabhorn Hospital

Abstract

Objective: To establish the typical dose for diagnostic radiography at Chulabhorn Hospital compared with the diagnostic reference level of Thailand and international diagnostic reference levels. Method: The collected data include kerma area product (KAP) from general X-rays, mean glandular dose from mammography, kerma area product (KAP) from interventional procedures, volume computed tomography dose index (CTDIvol), and dose length product (DLP) values from computed tomography (CT) studies. Our sample comprised 850 patients categorized as follows: 400 underwent general X-ray examination, 50 underwent mammography, 200 underwent interventional radiology procedures, and 200 underwent CT scans. Data were collected retrospectively from January to December 2021. The median was analyzed to yield the DRLs. The DRLs were compared to the Thai national DRL and international DRLs. Results: The diagnostic reference levels for general X-ray examination are as follows: 0.38 mGy.cm² for AP skull, 0.60 mGy.cm² for LAT skull, 0.10 mGy.cm² for PA chest, 0.69 mGy.cm² for AP abdomen, 0.70 mGy.cm² for AP pelvis, 1.82 mGy.cm² for AP lumbar spine, and 2.30 mGy.cm² for LAT lumbar spine. The MGD was 2.02 mGy from mammography. The DRLs of TACE and PTBD were 329.07 Gy.cm² and 3.58 Gy.cm², respectively. The DRLs of head, chest, and abdominal CT were CTDI_vol 46.35, CTDI_vol 8.83, and CTDI_vol 8.91 mGy, respectively. Conclusion: The majority of radiation doses at Chulabhorn Hospital are lower compared to the diagnostic reference levels of the Medical Sciences Department of Thailand in the years 2021 and 2023, as well as international reference levels.