Establishment of diagnostic reference levels for CT trunk examinations in the Western region of Saudi Arabia

Diagnostic reference levels (DRLs) are an important optimisation tool, which aid in identifying abnormally high dose levels. These are currently not available in Saudi Arabia, and this research aims to remedy this. CT dose data (DLP and CTDIvol) were collected for a minimum number of 10 adult patients of average size (60–80 kg) presenting for a range of CT examinations from public hospitals in the western region of Saudi Arabia. These include routine chest, high-resolution chest (HRCT), pulmonary angiography (CTPA), abdomen and pelvis (AP) and the combined chest, abdomen and pelvis (CAP) CT examinations. Mean values for each site were calculated, and the 75th percentile of DLP and CTDIvol was used as a basis for DRLs. Data for 550 patients were collected from 14 hospitals over a 7-month period. The rounded third-quartile CTDIvol and DLP were 18 mGy and 630 mGy cm−1 for chest CT, 20 mGy and 600mGy cm−1 for HRCT, 18 mGy and 480 mGy cm−1 for CTPA, 15 mGy and 800 mGy cm−1 for AP, and 16 mGy and 1040 mGy cm−1 for CAP, respectively. Regional DRLs have been proposed from this study. Dose variations across CT departments have identified an urgent need for optimisation to improve distribution of observed doses for CT examinations.