Skip to main content
Erschienen in: La radiologia medica 1/2021

01.01.2021 | MEDICAL PHYSICS

Provision of Italian diagnostic reference levels for diagnostic and interventional radiology

verfasst von: Gaetano Compagnone, Renato Padovani, Loredana D’Ercole, Antonio Orlacchio, Guglielmo Bernardi, Maria Antonietta D’Avanzo, Sveva Grande, Alessandra Palma, Francesco Campanella, Antonella Rosi

Erschienen in: La radiologia medica | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The diagnostic reference level (DRL) is a useful tool for the optimisation of medical exposures. Thus, a Working Party coordinated by the Italian National Institute of Health and the National Workers Compensation Authority has been formed to provide Italian DRLs, for both diagnostic and interventional procedures, to be used as appropriate for the implementation of the 2013/59 European Directive into the national regulation.

Materials and methods

The multidisciplinary Working Party was formed by professionals involved in diagnostic and interventional radiology medical exposures and started from a critical revision of both the literature and the results of previous Italian surveys. The procedures were divided into five sections for adult (projection radiography, mammography, diagnostic fluoroscopy, CT and interventional radiology) and two sections for paediatric patients (projection radiography and CT). The provided DRL values have been identified for “normal” adult patients and for age-classes of paediatric patients.

Results

Some of the DRL values provided by the Working Party are reported in this study as an example, divided by adult/paediatric patients, radiological technique and examination: specifically, DRLs for new radiological practices and new dose quantities as DRLs metric were introduced. The median value (rather than the mean) for each procedure, derived from a sample of patients, has to be compared with the corresponding DRL value, and dosimetric data related to a minimum number of patients should be collected for each examination.

Conclusions

The approach to the definition and use of DRLs through guidelines of national Authorities in collaboration with scientific Associations should simplify the periodical updating and could be useful for keeping the optimisation of medical exposures faithful to the development of radiological practice.
Literatur
1.
Zurück zum Zitat International Commission on Radiological Protection (1996) Radiological protection and safety in medicine. ICRP Publication 73. Ann ICRP 26(2):1–47 International Commission on Radiological Protection (1996) Radiological protection and safety in medicine. ICRP Publication 73. Ann ICRP 26(2):1–47
2.
Zurück zum Zitat International Commission on Radiological Protection (2007) The 2007 recommendations of the international commission on radiological protection. ICRP publication 103. Ann ICRP 37:1–332 International Commission on Radiological Protection (2007) The 2007 recommendations of the international commission on radiological protection. ICRP publication 103. Ann ICRP 37:1–332
3.
Zurück zum Zitat European Commission (1997) Council Directive 97/43/EURATOM of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466/Euratom. Off J Eur Commun No. L 180 European Commission (1997) Council Directive 97/43/EURATOM of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466/Euratom. Off J Eur Commun No. L 180
4.
Zurück zum Zitat Decreto Legislativo, 26 Maggio 2000 n.187 (2000) Attuazione della Direttiva 97/43/EURATOM in materia di protezione sanitaria delle persone contro i pericoli delle radiazioni ionizzanti connesse ad esposizioni mediche (in Italian). Supplemento Ordinario alla “Gazzetta Ufficiale”, n.157 del 7 luglio 2000 Decreto Legislativo, 26 Maggio 2000 n.187 (2000) Attuazione della Direttiva 97/43/EURATOM in materia di protezione sanitaria delle persone contro i pericoli delle radiazioni ionizzanti connesse ad esposizioni mediche (in Italian). Supplemento Ordinario alla “Gazzetta Ufficiale”, n.157 del 7 luglio 2000
5.
Zurück zum Zitat Commission European (2014) Council Directive 2013/59/EURATOM of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation. Off J Eur Union L13:1–73 Commission European (2014) Council Directive 2013/59/EURATOM of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation. Off J Eur Union L13:1–73
6.
Zurück zum Zitat Gruppo di Studio per l’Assicurazione di Qualità in radiodiagnostica (2007) Linee guida per la garanzia di qualità in radiologia diagnostica e interventistica (in Italian). Rapporti Istisan 07/26. Istituto Superiore di Sanità, Roma Gruppo di Studio per l’Assicurazione di Qualità in radiodiagnostica (2007) Linee guida per la garanzia di qualità in radiologia diagnostica e interventistica (in Italian). Rapporti Istisan 07/26. Istituto Superiore di Sanità, Roma
7.
Zurück zum Zitat Gruppo di Studio per l’Assicurazione di Qualità in Radiologia Diagnostica e Interventistica (2010) Linee guida per l’elaborazione di un manuale di qualità per l’utilizzo delle radiazioni ionizzanti in diagnostica per immagini e radiologia interventistica (in Italian). Rapporti Istisan 10/41. Istituto Superiore di Sanità, Roma Gruppo di Studio per l’Assicurazione di Qualità in Radiologia Diagnostica e Interventistica (2010) Linee guida per l’elaborazione di un manuale di qualità per l’utilizzo delle radiazioni ionizzanti in diagnostica per immagini e radiologia interventistica (in Italian). Rapporti Istisan 10/41. Istituto Superiore di Sanità, Roma
8.
Zurück zum Zitat Gruppo di Studio per l’Assicurazione di Qualità in radiologia interventistica (2015) Indicazioni operative per l’ottimizzazione della radioprotezione nelle procedure di radiologia interventistica (in Italian). Rapporti Istisan 15/41. Istituto Superiore di Sanità, Roma Gruppo di Studio per l’Assicurazione di Qualità in radiologia interventistica (2015) Indicazioni operative per l’ottimizzazione della radioprotezione nelle procedure di radiologia interventistica (in Italian). Rapporti Istisan 15/41. Istituto Superiore di Sanità, Roma
9.
Zurück zum Zitat Compagnone G, Padovani R, D’Avanzo MA, Grande S, Campanella F, Rosi A (2018) Summary of the Italian inter-society recommendations for radiation protection optimization in interventional radiology. Radiol Med 123:378–384CrossRef Compagnone G, Padovani R, D’Avanzo MA, Grande S, Campanella F, Rosi A (2018) Summary of the Italian inter-society recommendations for radiation protection optimization in interventional radiology. Radiol Med 123:378–384CrossRef
10.
Zurück zum Zitat Padovani R, Compagnone G, D’Ercole L, Orlacchio A, Bernardi G, Rosi A, Campanella F (2017) Livelli diagnostici di riferimento nazionali per la radiologia diagnostica e interventistica (in Italian). Rapporti Istisan 17/33. Istituto Superiore di Sanità, Roma Padovani R, Compagnone G, D’Ercole L, Orlacchio A, Bernardi G, Rosi A, Campanella F (2017) Livelli diagnostici di riferimento nazionali per la radiologia diagnostica e interventistica (in Italian). Rapporti Istisan 17/33. Istituto Superiore di Sanità, Roma
11.
Zurück zum Zitat Grande S, D’Ercole L, Palma A et al (2018) Risultati di un’indagine sulle esposizioni a radiazioni ionizzanti di operatori e pazienti in radiologia interventistica. Rapporti Istisan 18/17. Istituto Superiore di Sanità, Roma (in Italian) Grande S, D’Ercole L, Palma A et al (2018) Risultati di un’indagine sulle esposizioni a radiazioni ionizzanti di operatori e pazienti in radiologia interventistica. Rapporti Istisan 18/17. Istituto Superiore di Sanità, Roma (in Italian)
12.
Zurück zum Zitat Compagnone G, Campanella F, Domenichelli S et al (2012) Survey of the interventional cardiology procedures in Italy. Radiat Prot Dosim 150:316–324CrossRef Compagnone G, Campanella F, Domenichelli S et al (2012) Survey of the interventional cardiology procedures in Italy. Radiat Prot Dosim 150:316–324CrossRef
13.
Zurück zum Zitat Bernardi G, Piccaluga E, Padovani R (2013) Proposta di livelli di riferimento nazionali per la dose al paziente nelle procedure diagnostiche e interventistiche cardiache (in Italian). Società Italiana di Cardiologia Invasiva (GISE) 34° congress proceedings Bernardi G, Piccaluga E, Padovani R (2013) Proposta di livelli di riferimento nazionali per la dose al paziente nelle procedure diagnostiche e interventistiche cardiache (in Italian). Società Italiana di Cardiologia Invasiva (GISE) 34° congress proceedings
14.
Zurück zum Zitat Palorini F, Origgi D, Granata C, Matranga D, Salerno S (2014) Adult exposures from MDCT including multiphase studies: first Italian nationwide survey. Eur Radiol 24(2):469–483CrossRef Palorini F, Origgi D, Granata C, Matranga D, Salerno S (2014) Adult exposures from MDCT including multiphase studies: first Italian nationwide survey. Eur Radiol 24(2):469–483CrossRef
15.
Zurück zum Zitat Granata C, Origgi D, Palorini F, Matranga D, Salerno S (2015) Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey. Pediatr Radiol 45:695–705CrossRef Granata C, Origgi D, Palorini F, Matranga D, Salerno S (2015) Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey. Pediatr Radiol 45:695–705CrossRef
16.
Zurück zum Zitat Belli G, Bregant P, Isoardi P, Mari A, Nitrosi A, Nocetti L et al (2016) I sistemi di registrazione della dose. Report AIFM 13. Associazione Italiana di Fisica Medica (AIFM), Torino Belli G, Bregant P, Isoardi P, Mari A, Nitrosi A, Nocetti L et al (2016) I sistemi di registrazione della dose. Report AIFM 13. Associazione Italiana di Fisica Medica (AIFM), Torino
17.
Zurück zum Zitat van der Molen AJ, Schilham A, Stoop P, Prokop M, Geleijns J (2013) A national survey on radiation dose in CT in The Netherlands. Insights Imaging 4:383–390CrossRef van der Molen AJ, Schilham A, Stoop P, Prokop M, Geleijns J (2013) A national survey on radiation dose in CT in The Netherlands. Insights Imaging 4:383–390CrossRef
18.
Zurück zum Zitat European Commission (2014) Diagnostic reference levels in thirty-six European countries: part 2 of 2. EU Radiation Protection 180. Publications Office of the European Union, Luxembourg European Commission (2014) Diagnostic reference levels in thirty-six European countries: part 2 of 2. EU Radiation Protection 180. Publications Office of the European Union, Luxembourg
19.
Zurück zum Zitat Public Health England (2016) Guidance national diagnostic reference levels (NDRLs). UK Government, London Public Health England (2016) Guidance national diagnostic reference levels (NDRLs). UK Government, London
20.
Zurück zum Zitat Medical Council (2004) Diagnostic reference levels. Position Paper. Medical Council, Dublin Medical Council (2004) Diagnostic reference levels. Position Paper. Medical Council, Dublin
21.
Zurück zum Zitat Ufficio Federale Sanità Pubblica (2008) Circolare R-06-05. Valori diagnostici di riferimento per applicazioni di radiologia interventistica. Confederazione Svizzera, Bern Ufficio Federale Sanità Pubblica (2008) Circolare R-06-05. Valori diagnostici di riferimento per applicazioni di radiologia interventistica. Confederazione Svizzera, Bern
22.
Zurück zum Zitat Miller DL, Hiloi CM, Spelic DC (2012) Patient radiation doses in interventional cardiology in the U.S.: advisory data sets and possible initial values for U.S. reference levels. Med Phys 39:6276–6286CrossRef Miller DL, Hiloi CM, Spelic DC (2012) Patient radiation doses in interventional cardiology in the U.S.: advisory data sets and possible initial values for U.S. reference levels. Med Phys 39:6276–6286CrossRef
23.
Zurück zum Zitat Crowhurst JA, Whitby M, Thiele D, Halligan T, Westerink A, Crown S, Milne J (2014) Radiation dose in coronary angiography and intervenyions: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals. J Med Radiat Sci 61:135–141CrossRef Crowhurst JA, Whitby M, Thiele D, Halligan T, Westerink A, Crown S, Milne J (2014) Radiation dose in coronary angiography and intervenyions: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals. J Med Radiat Sci 61:135–141CrossRef
24.
Zurück zum Zitat PiDRL-European Diagnostic Reference Levels for Paediatric Imaging (2016) European guidelines on DRLs for paediatric imaging. Final complete draft. European Society of Radiology, Eurosafe Imaging, Wien PiDRL-European Diagnostic Reference Levels for Paediatric Imaging (2016) European guidelines on DRLs for paediatric imaging. Final complete draft. European Society of Radiology, Eurosafe Imaging, Wien
25.
Zurück zum Zitat European Commission (2012) Cone beam CT for dental and maxillofacial radiology-evidence based guidelines. EU radiation protection 172. Publications Office of the European Union, Brussels European Commission (2012) Cone beam CT for dental and maxillofacial radiology-evidence based guidelines. EU radiation protection 172. Publications Office of the European Union, Brussels
26.
Zurück zum Zitat Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L (eds) (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L (eds) (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg
27.
Zurück zum Zitat International Commission on Radiological Protection (2017). Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann ICRP 46(1):1–143 International Commission on Radiological Protection (2017). Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann ICRP 46(1):1–143
28.
Zurück zum Zitat European Communities (1996) European guidelines on quality criteria for diagnostic radiographic images. EUR 16260 EN. Office for Official Publications of the European Communities, Luxembourg European Communities (1996) European guidelines on quality criteria for diagnostic radiographic images. EUR 16260 EN. Office for Official Publications of the European Communities, Luxembourg
29.
Zurück zum Zitat European Communities (1996) European guidelines on quality criteria for diagnostic radiographic images in paediatrics. EUR 16261 EN. Office for Official Publications of the European Communities, Luxembourg European Communities (1996) European guidelines on quality criteria for diagnostic radiographic images in paediatrics. EUR 16261 EN. Office for Official Publications of the European Communities, Luxembourg
30.
Zurück zum Zitat European Communities (1999) European guidelines on quality criteria for computed tomography. EUR 16262 EN. Office for Official Publications of the European Communities, Luxembourg European Communities (1999) European guidelines on quality criteria for computed tomography. EUR 16262 EN. Office for Official Publications of the European Communities, Luxembourg
31.
Zurück zum Zitat European Commission (1999) Guidance on diagnostic reference levels (DRLs) for medical exposures. EU radiation protection 109. Direct-Gen Envir Nucl Saf Civ Prot European Commission (1999) Guidance on diagnostic reference levels (DRLs) for medical exposures. EU radiation protection 109. Direct-Gen Envir Nucl Saf Civ Prot
33.
Zurück zum Zitat European Commission (2014) Guidelines on radiation protection education and training of medical professionals in the European Union. EU Radiation Protection 175. Publications Office of the European Union, Luxembourg European Commission (2014) Guidelines on radiation protection education and training of medical professionals in the European Union. EU Radiation Protection 175. Publications Office of the European Union, Luxembourg
34.
Zurück zum Zitat European Commission (2019) European guidelines on diagnostic reference levels for paediatric imaging. EU radiation protection 185. Publications Office of the European Union, Brussels European Commission (2019) European guidelines on diagnostic reference levels for paediatric imaging. EU radiation protection 185. Publications Office of the European Union, Brussels
Metadaten
Titel
Provision of Italian diagnostic reference levels for diagnostic and interventional radiology
verfasst von
Gaetano Compagnone
Renato Padovani
Loredana D’Ercole
Antonio Orlacchio
Guglielmo Bernardi
Maria Antonietta D’Avanzo
Sveva Grande
Alessandra Palma
Francesco Campanella
Antonella Rosi
Publikationsdatum
01.01.2021
Verlag
Springer Milan
Erschienen in
La radiologia medica / Ausgabe 1/2021
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-020-01165-3

Weitere Artikel der Ausgabe 1/2021

La radiologia medica 1/2021 Zur Ausgabe

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.