Expected evolutions of the French diagnostic reference levels after the analysis of the 2009 and 2010 data

• Published in: Physica medica 2013-06, Vol.29, p.e13-e13
• Main Authors: Roch, P, Celier, D, Aubert, B
• Format: Article
• Language: English
• Subjects: Radiology
• ISSN: 1120-1797; 1724-191X
• DOI: 10.1016/j.ejmp.2013.08.044

Objectives Concerning Diagnostic reference levels (DRLs), IRSN's task is to analyse the data transmitted by the professionals of medical imaging, in order to update: the list of the relevant examinations, the dosimetric quantities and the numerical reference values. So, the collected data is representative of the national practices concerning the most common or radiation exposing examinations, taking into account technological developments and clinical practice. Materials and methods On the basis of the data collected between 2004 and 2008, the regulation was updated in 2011 (Decree of 24/ 10/2011). In 2009 and 2010 the dosimetric data analysis allows IRSN to strengthen and sometimes to complete the previous results, as well as to measure the evolution of: the regulation implementation, the clinical practices and the technologies implemented in conventional radiology, CT, and nuclear medicine. Results The DRL data transmission rate is heterogeneous and depends on the considered field of activity. With 67% of services having transmitted dosimetric evaluation in 2010, against 40% for CT and 20% for conventional radiology, nuclear medicine is the most assiduous. Nevertheless the annual periodicity is not followed by all services, regardless of the field of activity. For some exams, notable and recurring dosimetric differences between clinical practice and DRL are highlighted. On the other hand, it appears necessary that the DRL take into account new technologies affecting the delivered dose to the patient (CT of the PET-CT, iterative reconstruction in diagnostic CT) as well as the most radiation exposing procedures (diagnostic interventional radiology). Conclusions Following the analysis of data transmitted in 2009 and 2010, in addition to the update of the numerical values of the DRL for some examinations, the IRSN recommends to extend the scope of the NRD to the CT part of PET-CT examinations, even SPECT, and diagnostic interventional radiology. The reasons why, for certain exams, the average value is significantly higher than the DRL, with significant dispersion around this value, should also be investigated.