Establishing local diagnostic reference levels for high-resolution chest CT in the Gaza Strip during the COVID-19 pandemic

IF 2.8 3区物理与天体物理 Q3 CHEMISTRY, PHYSICAL

Radiation Physics and Chemistry Pub Date : 2025-10-13 DOI:10.1016/j.radphyschem.2025.113375

Husam H. Mansour, Noor Khairiah A Karim, Noor Diyana Osman, Rohayu Hami, Yasser S. Alajerami

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Abstract

Chest computed tomography (CT) was widely used during the COVID-19 pandemic, particularly where access to laboratory testing was limited. Its associated radiation exposure necessitates dose optimization through Diagnostic Reference Levels (DRLs). This study establishes the first local DRLs for high-resolution, non-contrast chest CT in the Gaza Strip and compares them with international benchmarks. A retrospective multicenter study was conducted on 600 adult patients scanned between September 2020 and December 2022 at three major hospitals using identical 64-slice multidetector CT systems (Philips Brilliance) and standardized protocols. The third-quartile values of the volume CT dose index (CTDIvol) and dose-length product (DLP) were used to define local DRLs, following International Commission on Radiological Protection recommendations (ICRP). The DRLs were 9.4 mGy for CTDIvol and 277 mGy cm for DLP. The CTDIvol was comparable to values in Norway (9 mGy), Saudi Arabia (8 mGy), and Taiwan (7.7 mGy), but lower than those reported in India (12 mGy), Canada (14.1 mGy), Nigeria (17 mGy), and South Africa (32 mGy). Similarly, the DLP was lower than Nigeria (735 mGy cm), Malaysia (600 mGy cm), South Africa (593 mGy cm), and Canada (521 mGy cm), while close to Norway (300 mGy cm) and Saudi Arabia (355 mGy cm). These findings show that Gaza's DRLs are well aligned with international standards despite resource limitations. Establishing these benchmarks marks a critical step toward radiation safety, protocol harmonization, and the creation of national CT guidelines in Palestine, supporting optimized imaging practice while safeguarding patients.

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在2019冠状病毒病大流行期间在加沙地带建立高分辨率胸部CT的当地诊断参考水平

在2019冠状病毒病大流行期间，胸部计算机断层扫描（CT）被广泛使用，特别是在获得实验室检测的机会有限的地方。其相关的辐射暴露需要通过诊断参考水平（DRLs）来优化剂量。本研究在加沙地带建立了第一个用于高分辨率、非对比胸部CT的本地drl，并将其与国际基准进行了比较。对2020年9月至2022年12月期间在三家大医院使用相同的64层多层CT系统（飞利浦华晨）和标准化方案扫描的600名成年患者进行了回顾性多中心研究。根据国际放射防护委员会（ICRP）的建议，使用体积CT剂量指数（CTDIvol）和剂量长度积（DLP）的第三四分位数值来确定局部drl。CTDIvol的DRLs为9.4 mGy， DLP为277 mGy cm。CTDIvol与挪威（9 mGy）、沙特阿拉伯（8 mGy）和台湾（7.7 mGy）相当，但低于印度（12 mGy）、加拿大（14.1 mGy）、尼日利亚（17 mGy）和南非（32 mGy）的报告值。同样，DLP低于尼日利亚（735兆瓦厘米）、马来西亚（600兆瓦厘米）、南非（593兆瓦厘米）和加拿大（521兆瓦厘米），而接近挪威（300兆瓦厘米）和沙特阿拉伯（355兆瓦厘米）。这些调查结果表明，尽管资源有限，但加沙的DRLs与国际标准保持一致。建立这些基准标志着巴勒斯坦朝着辐射安全、协议协调和创建国家CT指南迈出了关键一步，在保护患者的同时支持优化成像实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Physics and Chemistry 化学-核科学技术

CiteScore

5.60

自引率

17.20%

发文量

574

审稿时长

12 weeks

期刊介绍： Radiation Physics and Chemistry is a multidisciplinary journal that provides a medium for publication of substantial and original papers, reviews, and short communications which focus on research and developments involving ionizing radiation in radiation physics, radiation chemistry and radiation processing. The journal aims to publish papers with significance to an international audience, containing substantial novelty and scientific impact. The Editors reserve the rights to reject, with or without external review, papers that do not meet these criteria. This could include papers that are very similar to previous publications, only with changed target substrates, employed materials, analyzed sites and experimental methods, report results without presenting new insights and/or hypothesis testing, or do not focus on the radiation effects.