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SC 4-3: Diagnostic Reference Levels in Medical Imaging: Recommendations for Application in the United States  

The Committee held its second meeting at NCRP headquarters on October 27-28, 2009.

It was decided that the report will contain a discussion of the history and applications of diagnostic reference levels (DRLs) in the United States, Europe, and the rest of the world.  A number of examinations will be selected for the development of reference levels, including computed tomography (CT), interventional radiology, and nuclear medicine. DRLs will be selected based on patient dose surveys and data available through various organizations including the U.S. Food and Drug Administration and the American College of Radiology (ACR), as well as from peer-reviewed publications.

The Committee held a teleconference on March 2, 2010.The Committee discussed the CT dose data available from two sources—ACR and the Nationwide Evaluation of X-Ray Trends (NEXT).  ACR data is extensive but it is a biased sample as it is only from facilities seeking accreditation.  The NEXT data analysis will probably not be completed until October 2010 and the report must then go out for review to the Conference of Radiation Control Program Directors (CRCPD) and others.

In a subsequent teleconference with Drs. Brink, Tenforde and Gray it was decided to proceed using the preliminary NEXT data for the August 15 draft, making any changes as a result of the CRCPD review prior to final publication of the NCRP SC 4-3 report.

The Committee has decided to provide only one DRL for intraoral radiography.  In the past, two DRLs, or suggested exposure levels, were provided—one for D‑speed and one for E-F-speed dental film.  (E-F-speed film requires about one-half of the radiation dose compared to D-speed film.)  Providing only one DRL is an approach similar to medical radiography where only one DRL is provided regardless of the speed of the image receptor.  This may encourage more dental facilities to convert to E-F-speed film with a subsequent reduction in radiation dose to both the patients and staff.

Most of the text is presently in draft form.  The next teleconference will be on May 21, 2010.  A meeting will be held at the NCRP Headquarters the week of June 7, 2010, followed by a teleconference the week of July 12, 2010.  The final text is to be submitted to the NCRP technical staff consultant for editing by July 30, 2010 for submission to NCRP by August 15.
 
Two consultants have been added to NCRP SC 4-3.  Dr. Jerrold Bushberg (School of Medicine, University of California, Davis) will provide input for the nuclear medicine section of the report.  Dr. James Duncan (Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology) will provide input for the section on interventional radiology.

SC 4-2 Population Monitoring and Decontamination Following
a Nuclear or Radiological Incident >

SC 4-4 Risks of Ionizing Radiation to the Developing Embryo, Fetus and Nursing Infant >

 

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