A recipe to establish DRLs in your country

A recipe to establish DRLs in your country IAEA International Atomic Energy Agency

The process • 1. Collect the data in a number of rooms in a number of hospitals • 2. Collate the room data into a national database • 3. Analyse the national database • 4. Set national DRL values IAEA

Ownership • Who (persons, organisations) will you contact to drive the process and perform the activities in each part of the process, as follows? • Promote awareness, engender enthusiasm and participation, handle distribution of the data collection forms, …. • Set up and maintain the national database • Perform the analysis and set the DRL values • Putting the DRL values into the regulatory framework IAEA

What modality or modalities? • Radiography • Most common in all countries • Don’t need a dosemeter • Fluoroscopy & IGIP • Use in Africa varies, but in many countries it is not a major modality • Complex • Need KAP meter or just screening time IAEA

What modality or modalities? • CT • Manageable numbers • Higher doses • Dose metrics (CTDIvol, DLP) displayed and available in DICOM header/dose report • Mammography • Modality not so suited to DRLs IAEA

What age groups? • Adults • Higher numbers of patients • Children • Smaller patient numbers • More complex analysis for DRLs • More complex to use DRLs IAEA

What procedures or examinations? • DRLs are underpinned by the desire to reduce cancer risk • Extremities – no • Head – not a priority for radiography • Trunk • Chest • Abdomen/pelvis • L spine IAEA

Radiography • Projection or examination? • DRL is a tool for optimization • More effective if the examination is broken down into its component projections • Can not simply add the ESAKs, anyway IAEA

CT • Clinical purpose versus volume? • Volume approach is simpler, but need to exclude special exams IAEA

Designing data collection forms • What data parameters will you ask for in the room data collection form? • Look at examples on the DVD • Use the links to websites given in the presentations • Look at the documents referenced • Ask for only parameters that you will use. IAEA

Number of rooms? • What sample size to use – number of rooms • Needs to be feasible • If small numbers of units (e. g. CT), maybe include all units • Geographical representation • Approximately in proportion IAEA

Selection of patients per room? • How many? Minimum? • 10 • Weight bounds? • Aim to represent your population IAEA

Good luck IAEA