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Towards establishment of diagnostic reference levels based on clinical indication in the state of Qatar

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submitted on 2023-10-03, 09:14 and posted on 2023-10-03, 09:23 authored by Huda AlNaemi, Virginia Tsapaki, Ahmed J. Omar, Maryam AlKuwari, Amal AlObadli, Shady Alkhazzam, Antar Aly, Mohammad Hassan Kharita


The objectives of this study were to: 1) evaluate patient radiation exposure in CT and 2) establish CT Diagnostic Reference Levels (DRL)s based on clinical indication (CI) in Qatar.

Materials and Methods

Patient data for 13 CIs were collected using specially designed collection forms from the dose management software (DMS) of Hamad Medical Corporation (HMC), the main Qatar healthcare provider. The methodology described in the International Commission on Radiological Protection (ICRP) Report 135 was followed to establish national clinical DRLs in terms of Volumetric Computed Tomography Dose Index (CTDIvol) and total Dose Length Product (DLPt). Effective dose (Ef) was estimated by DMS using DLPt and appropriate conversion factors and was analyzed for comparison purposes.


Data were retrospectively collected for 896 adult patients undergoing CT examinations in 4 hospitals and 7 CT scanners. CT for Diffuse infiltrative lung disease imparted the lowest radiation in terms of CTDIvol (5 mGy), DLPt (181 and Ef (3.6 mSv). Total body CT for severe trauma imparted the highest DLPt (3137 and Ef (38.6 mSv) of all CIs with a CTDIvol of 15 mGy. Rounded Third quartile CTDIvol and DLPt values were defined as the Qatar CT clinical DRLs. Comparison was limited due to sparse international literature. When this was possible data were lower or comparable with other studies.


This is the first study reporting national clinical DRLs in Asia and second one internationally after UK. For accurate comparison between studies, systemized CI nomenclature must be followed by researchers.

Other Information

Published in: European Journal of Radiology Open
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Open Access funding provided by the Qatar National Library



  • English


Elsevier BV

Publication Year

  • 2020

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License

Institution affiliated with

  • Hamad Medical Corporation
  • Weill Cornell Medicine - Qatar

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