Local Diagnostic Reference Levels (LDRLs) for routine X-ray examinations in Morocco

In Morocco, the radiation protection of patients undergoing medical imaging examinations using ionizing radiation sources is now governed by specific provisions of Chapter VII of Law no142-12 (Loi no142-12 – AMSSNuR, 2015). The principle of justification of procedures and the principle of optimization of doses delivered constitute the basis of the legislation governing medical exposure. DRLs are considered as an important optimization tool encouraging healthcare professionals to optimize their practice and assure a better patient safety. In this survey, Local Diagnostic Reference Levels (LDRLs) were established for the eight most frequent examinations in Morocco. Data from 1747 patients were collected from seven regional hospitals. The proposed LDRLs were defined as the 75th percentile of the mean entrance surface dose distribution (ESD) in mGy using the indirect dosimetry method according to the IAEA Report Series No. 457. The LDRLs values reported in this study were for the eight examinations: skull (PA) 2.8 mGy, chest (PA) 0.51 mGy, abdomen (AP) 7.6 mGy, pelvis (AP) 6.45 mGy, lumbar (AP) 7.8 mGy, lumbar (Lat) 10.7 mGy, cervical (AP) 2.2 mGy, and cervical (Lat) 2.4 mGy. The DRLs reported in Morocco were compared with those of international authorities and other countries: IRSN (France), NRPB (UK), Japan, Sudan, and Iran. The present work assesses the local DRLs in Morocco and constitutes a starting point that will provide professionals with a tool to help them optimize the doses delivered to patients. Furthermore, the definition of national DRLs by radiography is an essential step in the process of optimizing medical exposures.