Evaluation of the Typical Dose Values in Patients Undergoing CT Scan Examinations at Andalas University Hospital

Ramacos Fardela (1), Rani Delvihardini (2), Ida Bagus Gede Putra Pratama (3), Dian Milvita (4), Amel Oktavia (5)
(1) Department of Physics, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
(2) Department of Physics, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
(3) Nuclear Energy Regulatory Agency, Jakarta, Indonesia
(4) Department of Physics, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
(5) Radiology Installation of Andalas University Hospital, Padang, Indonesia
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R. Fardela, R. Delvihardini, I. B. G. P. Pratama, D. Milvita, and A. Oktavia, “Evaluation of the Typical Dose Values in Patients Undergoing CT Scan Examinations at Andalas University Hospital”, Int. J. Adv. Sci. Eng. Inf. Technol., vol. 15, no. 3, pp. 693–700, Jun. 2025.
In the medical field, X-rays are used in diagnostic radiology and radiotherapy. The Computed Tomography Scanner (CT scan) is a diagnostic radiology modality that employs X-rays. It is crucial to protect patients from excessive radiation exposure by optimizing measures, as CT scans deliver higher doses than other modalities. This study aims to determine, compare, and evaluate typical dose values at Andalas University (Unand) Hospital with Sumatra Regional, National, and several other countries' Diagnostic Reference Levels (DRLs). It also examines the correlation between Dose Length Product (DLP) and Computed Tomography Dose Index Volume (CTDIVol) concerning exposure parameters (mAs). Data from 225 adult patients undergoing non-contrast CT scans of the head, chest, abdomen, and contrast-enhanced abdomen at Unand Hospital were used to determine typical dose values from the median (Q2). The findings indicate that non-contrast head CT scans at Unand Hospital yielded the highest CTDIVol and DLP values. The non-contrast abdominal CT scan had the lowest DLP value, while the contrast-enhanced abdominal CT scan had the lowest CTDIVol value. The non-contrast head and contrast-enhanced abdominal CT scans exceeded Sumatra Regional and National DRLs, while the typical dose value for non-contrast abdominal CT scans at Unand Hospital did not exceed these DRLs. The hospital's typical CTDIVol value is relatively lower, whereas the DLP is relatively higher compared to DRL values of several countries. The study shows a strong correlation between CTDIVol and DLP values with tube current.

K. C. Eze et al., ‘Diagnostic reference levels (DRLs) for chest radiography, non-contrast head computed tomography and mammography examinations in Nigeria: review of national data’, Chinese J. Acad. Radiol., vol. 5, no. 2, pp. 99–106, 2022, doi:10.1007/s42058-022-00097-3.

R. Fardela, D. Milvita, L. A. Rasyada, M. Almuhayar, F. Diyona, and A. Mousa, ‘Radiation Dose Evaluation for Radiotherapy Workers at Unand Hospital Using Four-Element Thermoluminescence Dosimetry’, J. Ilm. Pendidik. Fis. Al-Biruni, vol. 12, no. 2, p. 143, 2023, doi: 10.24042/jipfalbiruni.v12i2.18101.

R. Fardela, D. Milvita, M. Almuhayar, D. Mardiansyah, L. A. Rasyada, and L. M. Hakim, ‘Classification of Thoracic X-Ray Images of COVID-19 Patients Using the Convolutional Neutral Network (CNN) Method’, J. Comput. Sci., vol. 20, no. 4, pp. 357–364, 2024, doi:10.3844/jcssp.2024.357.364.

M. Rawashdeh, C. Saade, D. S. Al Mousa, M. Abdelrahman, P. Kumar, and M. McEntee, ‘A new approach to dose reference levels in pediatric CT: Age and size-specific dose estimation’, Radiat. Phys. Chem., vol. 205, no. November 2022, p. 110698, 2023, doi:10.1016/j.radphyschem.2022.110698.

D. Joseph Zira et al., ‘Clinical indication-based diagnostic reference levels for paediatric head computed tomography examinations in Kano Metropolis, northwestern Nigeria’, Radiography, vol. 27, no. 2, pp. 617–621, 2021, doi: 10.1016/j.radi.2020.11.021.

O. A. Bawazeer, ‘Assessment of diagnostic reference levels awareness and knowledge amongst CT radiographers in Saudi Arabia’, J. Radiat. Res. Appl. Sci., vol. 15, no. 2, pp. 98–105, 2022, doi:10.1016/j.jrras.2022.05.009.

E. Gyan, C. Subaar, G. Edusei, and L. Antwi Nyarko, ‘Paediatric computed tomography diagnostic reference levels in Africa: A systematic review’, J. Med. Radiat. Sci., pp. 1–9, 2024, doi:10.1002/jmrs.824.

M. H. Kharita et al., ‘Relation between age and CT radiation doses: Dose trends in 705 pediatric head CT’, Eur. J. Radiol., vol. 130, no. May, p. 109138, 2020, doi: 10.1016/j.ejrad.2020.109138.

Y. Inoue, H. Itoh, A. Waga, R. Sasa, and K. Mitsui, ‘Radiation Dose Management in Pediatric Brain CT According to Age and Weight as Continuous Variables’, Tomography, vol. 8, no. 2, pp. 985–998, 2022, doi: 10.3390/tomography8020079.

A. Arriaga, C. Gonçalves, P. Teles, J. Santos, P. Simãozinho, and P. Sousa, ‘Establishment of local diagnostic reference levels for abdomen and chest radiographies in the region of Algarve, Portugal’, Eur. J. Radiol., vol. 170, no. December 2023, 2024, doi:10.1016/j.ejrad.2023.111248.

H. Osman et al., ‘Evaluation of CT dose and establishment of local DRLs for abdomen and pelvis examinations in hospitals in Taif City, Saudi Arabia’, Radiat. Phys. Chem., vol. 202, no. May 2022, p. 110206, 2023, doi: 10.1016/j.radphyschem.2022.110206.

F. Yang and L. Gao, ‘Age-based diagnostic reference levels and achievable doses for paediatric CT: a survey in Shanghai, China’, J. Radiol. Prot., vol. 44, no. 2, 2024, doi: 10.1088/1361-6498/ad3ce5.

Y. Inoue, H. Itoh, K. Nagahara, H. Hata, and K. Mitsui, ‘Relationships of Radiation Dose Indices with Body Size Indices in Adult Body Computed Tomography’, Tomography, vol. 9, no. 4, pp. 1381–1392, 2023, doi: 10.3390/tomography9040110.

M. K. Saeed and Y. Almalki, ‘Assessment of computed tomography radiation doses for paediatric head and chest examinations using paediatric phantoms of three different ages’, Radiography, vol. 27, no. 2, pp. 332–339, 2021, doi: 10.1016/j.radi.2020.09.007.

N. A. Muhammad, A. Sabarudin, N. Ismail, and M. K. A. Karim, ‘A systematic review and meta-analysis of radiation dose exposure from computed tomography examination of thorax-abdomen-pelvic regions among paediatric population’, Radiat. Phys. Chem., vol. 179, no. August 2020, p. 109148, 2021, doi:10.1016/j.radphyschem.2020.109148.

K. Radaideh, A. Al-Radaideh, R. M. Ramli, A. Saleh, and R. Alshayeb, ‘Establishment of national diagnostic dose reference levels (DRLs) for routine computed tomography examinations in Jordan’, Polish J. Med. Phys. Eng., vol. 29, no. 1, pp. 26–34, 2023, doi: 10.2478/pjmpe-2023-0003.

K. Alzimami et al., ‘Evaluation of pediatric radiation doses in computed tomography procedures in the Kingdom of Saudi Arabia’, Radiat. Phys. Chem., vol. 188, no. June, p. 109679, 2021, doi:10.1016/j.radphyschem.2021.109679.

K. M. Aloufi et al., ‘Assessing Effective Doses and Proposing DRLs for Pediatric CT Procedures in Madinah (Single Hospital), Saudi Arabia’, Appl. Sci., vol. 14, no. 17, 2024, doi: 10.3390/app14177583.

M. M. U. D. Malik, M. Alqahtani, I. Hadadi, A. G. M. AlQhtani, and A. Alqarni, ‘An Analysis of Computed Tomography Diagnostic Reference Levels in India Compared to Other Countries’, Diagnostics, vol. 14, no. 15, pp. 1–16, 2024, doi: 10.3390/diagnostics14151585.

M. Abyar, M. Mahdavi, and G. H. Haddadi, ‘Establishing local Diagnostic Reference Level for Adult Patients in Computed Tomography Examination in Kohgiluyeh and Boyer-Ahmad province’, Iran. J. Med. Phys., vol. 18, no. 4, pp. 247–254, 2021, doi:10.22038/ijmp.2020.46309.1724.

J. Guðjónsdóttir, S. S. Michelsen, G. Björnsdóttir, and V. K. Guðmundsdóttir, ‘CT doses based on clinical indications. New national DRL’s in Iceland’, Phys. Medica, vol. 109, no. March, 2023, doi: 10.1016/j.ejmp.2023.102576.

O. Bwanga and E. Chanda, ‘Challenges in Radiation Protection in Healthcare: A Case of Zambia’, EAS J. Radiol. Imaging Technol., vol. 2, no. 1, pp. 7–14, 2020, doi: 10.36349/EASJRIT.2020.v02i01.002.

S. Rao et al., ‘Systematic Review on Diagnostic Reference Levels for Computed Tomography Examinations in Radiation Therapy Planning’, Diagnostics, vol. 13, no. 6, pp. 1–13, 2023, doi:10.3390/diagnostics13061072.

P. R. Costa et al., ‘Typical values statistical analysis for adult chest and abdomen-pelvis CT examinations’, Radiat. Phys. Chem., vol. 221, no. November 2023, 2024, doi: 10.1016/j.radphyschem.2024.111669.

T. Amalia, B. Zulkarnaien, C. Anam, K. Nurcahyo, H. Tussyadiah, and D. E. Pradana, ‘The Establishment of Institutional Diagnostic Reference Levels (DRLs) in the Cipto Mangunkusumo Hospital’, Atom Indones., vol. 48, no. 2, pp. 159–167, 2022, doi: 10.17146/aij.2022.1131.

R. Jannah, R. Munir, and E. R. Putri, ‘Determination of the Diagnostic Reference Level ( DRL ) in Samarinda Hospitals’, Atom Indones., vol. 49, no. 3, pp. 145-150, 2023, doi: 10.55981/aij.2023.1285.

W. S. Tan, S. Foley, and M. L. Ryan, ‘Investigating CT head diagnostic reference levels based on indication-based protocols – a single site study’, Radiography, vol. 29, no. 4, pp. 786–791, 2023, doi:10.1016/j.radi.2023.05.003.

J. P Guilford, Fundamental Statistic in Psychology and Education, Third Edition. Mc Graw-Hill Book Company, 1956.

L. Arlany et al., ‘Establishment of CT diagnostic reference levels (DRLs) for a Singapore healthcare cluster’, Radiography, vol. 29, no. 1, pp. 184–189, 2023, doi: 10.1016/j.radi.2022.11.002.

A. M. Ahmed et al., ‘Establishment of a local diagnostic reference level for computed tomography chest and abdomen in two different cities in Saudi Arabia’, Appl. Radiat. Isot., vol. 204, no. December 2023, p. 111147, 2024, doi: 10.1016/j.apradiso.2023.111147.

M. Oliveira Bernardo et al., ‘Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study’, Eur. J. Radiol., vol. 169, no. August, 2023, doi:10.1016/j.ejrad.2023.111191.

C. Lee et al., ‘Organ dose estimation accounting for uncertainty for pediatric and young adult CT scans in the United Kingdom’, Radiat. Prot. Dosimetry, vol. 184, no. 1, pp. 44–53, 2019, doi:10.1093/rpd/ncy184.

I. Shirazu et al., ‘Measurements of CTDI and DLP from CT image data for paediatrics radiological performance evaluation and dose optimisation in Ghana’, Int. J. Sci. Res. Sci. Technol., no. December, pp. 162–166, 2018, doi: 10.32628/ijsrst18401134.

A. Lyons et al., ‘Expansion of Typical Values for Paediatric Patients in Ireland and Comparison with Published DRLs - Experiences of a Single Institution’, J. Med. Imaging Radiat. Sci., vol. 55, no. 3, p. 101421, 2024, doi: 10.1016/j.jmir.2024.04.014.

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