Assessing the Accuracy and Efficiency of Dose Management Systems in Establishing Local Diagnostic Reference Levels for Adult CT Examinations

Abstract

Background: Computed tomography (CT) contributes significantly to radiation exposure due to its high dose levels. Diagnostic Reference Levels (DRLs) are essential tools for optimizing clinical procedures and minimizing excessive exposure. This study compares manual data collection with an automated Dose Management System (DMS) to determine local diagnostic reference levels (LDRLs) for common adult CT exams at Sharjah Zayed Military Hospital.

Methods: A comparative study was conducted using two data collection methods: (1) manual extraction of radiation dose data from CT scanners and DICOM headers, and (2) an automated DMS. The study evaluated sample size, data collection efficiency, and statistical agreement in CT dose index-volume (CTDIvol) and dose length product (DLP) values between the two methods.

Results: The automated system significantly increased the sample size (479 vs. 80) and reduced data collection time by 75%. Statistical analysis demonstrated strong agreement between both methods, with percentage differences in median CTDIvol and DLP values ranging from –0.36% to 24.7% across CT protocols. Additionally, the DMS improved data standardization.

Conclusion: DMS provides a more efficient and scalable approach to establishing LDRLs, enhancing data collection, standardization, and radiation dose monitoring in CT imaging. Integrating DMS into clinical practice supports radiation dose optimization, improves data accuracy, and enhances patient safety and quality assurance.