title: CT chest abdomen pelvis doses in Scotland: has the DRL had its day?
abstract: OBJECTIVE
  This article reports on a pilot study designed to collect dose data representative of current CT chest abdomen pelvis (CAP) practice in Scotland, make any immediately obvious interventions and to identify if the current UK diagnostic reference level (DRL) of 940 mGy cm is still appropriate. The aims are to identify if a Scotland-wide picture archiving and communication system (PACS)-based dose audit of a number of CT examinations is likely to have value in terms of optimization of patient doses and to comment on the significance of the results in terms of future optimization strategies.
  
  
  METHODS
  Dose audit of CT CAP examinations at 32 different scanner sites across Scotland using accepted data collection and analysis methods. The minimum sample size was 30.
  
  
  RESULTS
  RESULTS indicate that CT CAP doses are lower than those previously reported (median, 800 mGy cm, 75th percentile 840 mGy cm) but follow a distribution that is not in keeping with the concept of DRLs as presently understood or implemented.
  
  
  CONCLUSIONS
  There is value in a PACS-based dose audit project to provide serial snapshots of patient doses as optimization efforts take place and to revise current knowledge about CT doses. In our opinion, the results call into question whether DRLs or the concept of "achievable dose" are suitable for devising optimization strategies once a certain degree of optimization has taken place.
  
  
  CONCLUSIONS
  The results reported here suggest that it may be time to take a different approach to optimization, concentrating on tools that are more refined than the DRL, which may have become more of a compliance tool than an aid to optimization.
authors: 1 Department of Medical Physics, Ninewells Hospital, NHS Tayside, Dundee, UK.
authors: D G
authors: DG
authors: Sutton
authors: S
authors: S
authors: McVey
authors: D
authors: D
authors: Gentle
authors: A J
authors: AJ
authors: Hince
authors: N
authors: N
authors: MacDonald
authors: S
authors: S
authors: McCallum
mesh_terms: D006801:Humans; D010388:Pelvis / Q000000981:diagnostic imaging*; D010808:Physical Examination; D010865:Pilot Projects; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000592:standards*; D013902:Radiography, Thoracic / Q000592:standards*; D011873:Radiology Information Systems; D012062:Relative Biological Effectiveness; D012606:Scotland; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*