Diagnostic Reference Level for CT Examinations in Hospitals in the Republic of Congo

Francis Akiana^1, , Olivia Firmine Galiba Atipo Tsiba², Joel Bazoma³, Abraham Mayoke³, Régis Moyikoua⁴, Guy Apollinaire Mensah⁵ and Daton Medenou¹

¹University of Abomey Calavi, Doctoral School of Engineering Sciences, Department of Radiobiology, BP2009. Cotonou, Benin

²Marien Ngouabi University, Faculty of Health Sciences, PO BOX 69. Brazzaville Congo

³Marien Ngouabi University, Faculty of Science and Techniques, PO BOX 69. Brazzaville, Congo

⁴Hospital center universal of Brazzaville and Imagery medical service

⁵Laboratoire de Zootechnie et Faune, Faculté des Sciences, Arts et Lettres du Bénin, Université d'Abomey-Calavi, 01 B.P. 2359 Recette Principale, Cotonou

Cite this paper:
Francis Akiana, Olivia Firmine Galiba Atipo Tsiba, Joel Bazoma, Abraham Mayoke, Régis Moyikoua, Guy Apollinaire Mensah and Daton Medenou. Diagnostic Reference Level for CT Examinations in Hospitals in the Republic of Congo. American Journal of Pharmacological Sciences. 2024; 12(1):8-16. doi: 10.12691/ajps-12-1-2

Abstract

Ionizing irradiations doses were delivered to paediatric and adults patients during CT scans examinations are caused various effects on tissues organs exposed. This can be induced various risks consequences including cancers if overdosed. Administered doses are regulated compared to international standards worldwide. The aim of this study was to evaluate dose delivered to patients during CT scans in four hospitals in the republic Congo. A total of 350 adult and 76 paediatric patients were surveyed especially cerebral chest, Pelvis-abdominal and thoracic abdomino-pelvis. We were obtained adult DPL mean values in adults ranging from 1896.04 ± 57.08 mGy.cm to 3018.45 ± 1917.13 mGy.cm with contrast product. Whereas, without a contrast product, value is varied from 1244.01 ± 694.18 mGy.cm when the highest in the skull is 1943.86 ± 72.05 mGy.cm. We were accessed high effective doses compared to ICPR 60 (4.08 ± 1.62 - 42.88 ± 25.53) and ICPR 103 (03.69 ± 1.47 - 40.02 ± 23.83). Paediatric patients were received doses ranging between 193.00 to 347.55mG.cm in the skull in hospital A. In the age-group of < 1- 15 years, all centers were received from 6.46 to 19.84 mGy.cm. The highest is meant for adults in the cerebral were 133.35 mSv whereas others organs were received between 39.58 to 73.81 mSv with contrast. The paediatric patients are reached 347.55 mSv in the cerebral with contrast product and other organs were received up to 19.84 mSv. Our studies were revealed that doses were delivered to patients during CT scans in the republic of the Congo are all higher than the standard. This is due to be unregulated, administered to patients, the vestuosity of the equipment used, and the lack of technical training for technician’s radiologists’ on dose reduction. These results were raised an alarm to establish a dose level reduction and national regulatory body to be convened international standards on doses reduction countrywide.

Keywords:
ionizing radiation tomodensimetry parameters patient no reglementary

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References:

[1]	J. Aldrich A, Bilawich MJR: “Radiation doses to patients receiving computed tomography examinations in British Columbia,” Can. Assoc. Radiol. J., vol. 57, no. 2, pp. 79–85, 2006.
[2]	IRSN: “IMAGERIE PÉDIATRIQUE Informations pour faciliter le dialogue sur les bénéfices et les risques entre professionnels et patients,” 2022.
[3]	CIPR 105: Protection radiologique en médecine. 2004.
[4]	WHO: “Ionizing Radiation: Health Effects and Protective Measures,” 2016. [Online]. Available:https:// www.who.int/ fr/news-room/fact-sheets/detail/ionizing-radiation-health-effects-and-protective-measures
[5]	Beauvais-March M, Valero A, Biau N, Hocine JL, Rehel M: Bourguignon:“L’exposition des patients en radiodiagnostic : Bilan de l’étude dosimétrique réalisée en 2001–2003 dans 24 services français de radiologie,” Radioprotection, vol. 39, no. 4, pp. 493–511, 2004.
[6]	De González, Darby S: “Risk of cancer from diagnostic X-rays : estimates for the UK and 14 other countries,” vol. 363, pp. 345–351, 2004.
[7]	IRSN: “IMAGERIE PÉDIATRIQUE Informations pour faciliter le dialogue sur les bénéfices et les risques entre professionnels et patients,” pp. 1–94, 2022.
[8]	A. Kaul B, Bauer J, Bernhardt D: Nosske, and R. Veit, “Original article Effective doses to members of the public from the diagnostic application of ionizing radiation in Germany ,” vol. 1132, pp. 1127–1132, 1997.
[9]	Sari-Minodier D, Paul F, Coletti T, Orsière A, Botta: “Évaluation dosimétrique et biogénotoxicologique de l ’ exposition aux rayonnements ionisants,” vol. 41, no. 5, pp. 209–226, 2007.
[10]	ICRP: “Managing Patient Dose in Digital Radiology,” ICRP Ann. ICRP, vol. 34, no. 1, pp. 1–73, 2004.
[11]	ICPR 60: “New Quantities and Units As Given in Icrp Publication 60,” p. 8, 1990, [Online]. Available: http:// www.iaea.org/ inis/collection/NCLCollectionStore/_Public/26/071/26071238.pdf
[12]	ICPR 103: “ICPR 103: The 2007 Recommendations of the International Commission on Radiological Protection,” Ann. ICRP, vol. 37, no. 2–4, p. 39, 1967.
[13]	Benabdallah N: “Optimisation de la dosimétrie en alphathérapie par approche multi-échelle : application au traitement des métastases osseuses par le 223 Ra,” 2017.
[14]	Doudenkova V: “Enjeux éthiques en radiologie diagnostique : comment la bioéthique peut-elle contribuer à une meilleure radioprotection du patient?,” 2015.
[15]	Cristy M, Eckerman KF: “Specific absorbed fractions of energy at various ages from internal photon sources: 5, Fifteen-year-old male and adult female,” United States, 1987.
[16]	Muhammad NA, Khalis Abdul Karim M, Hassan HA, Kamarudin MA, Ding Wong J H, Hoong K: “Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia,” Diagnostics, vol. 10, no. 591, pp. 1–14, 2020.
[17]	Shao YH, Tsai K, Kim S, Wu YJ, Demissie K: “Exposure to tomographic scans and cancer risks,” Oxford Univ. Press, vol. 4, no. 1, pp. 1–7, 2020.
[18]	Torp C, Olerud H, Einarsson G, Gron P, Leitz W, Servomaa A: “Use of the EC quality criteria as a common method of inspecting CT laboratories- a pilot project by the Nordic Radiation protection Authorities,” Vienna, Austria, 2001.
[19]	European Commission, Radiation Protection Raport N°185 :European Guidelines on Diagnostic Reference Levels for Peadiatric Imaging. Luxembourg: Publications Office of the European Union, 2018.
[20]	Aiea RADEL:“Rapport annuel de l’aiea 2019,” 2019.
[21]	Tsapaki V, Kottou S, Papadimitriou D: “Application of European Commission reference dose levels in CT examinations in Crete , Greece,” vol. 74, no. September, pp. 836–840, 2001.
[22]	Li X: “Patient-specific radiation dose and cancer risk estimation in CT: Part II. Application to patients,” Med. Phys., vol. 38, no. 1, pp. 408–419, 2011.
[23]	Shrimpton PC, Hillier MC, Lewis MA, Dunn M: “National survey of doses from CT in the UK : 2003,” vol. 79, no. December, pp. 968–980, 2006.
[24]	Pearce MS: “Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours : a retrospective cohort study,” Lancet, vol. 380, no. 9840, pp. 499–505, 1985.
[25]	Baysson H: “Suivi d’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique,” Radioprotection, vol. 48, no. 1, pp. 97–113, 2013.
[26]	European Commission:“RADIATION PROTECTION 150,” in A Critical Review of the Draft 2005 ICRP Recommendations, 2008, no. 150, pp. 1–59.
[27]	Osei EK, Darko J: “A Survey of Organ Equivalent and Effective Doses from Diagnostic Radiology Procedures,” vol. 2013, 2013.
[28]	Mokubangele CM, Moifo B, Fotsin JG: “Évaluation de la dose patient en scanographie pédiatrique dans deux hôpitaux universitaires à Yaoundé Cameroun,” vol. 47, pp. 533–542, 2012.
[29]	Matsubara K: “Assessment of an organ-based tube current modulation in thoracic computed tomography,” J. Appl. Clin. Med. Phys., vol. 13, no. 2, pp. 148–158, 2012.
[30]	De la Santé M: “Radioprotection en radiologie-Grands établissements Procédures de sécurité pour l’installation , l’utilisation et le contrôle des appareils à rayons X dans les grands établissements radiologiques médicaux Code de sécurité 35,” 2008, pp. 1–94. [Online]. Available:https:// www.canada.ca/fr/sante-canada/services/ sante-environnement-milieu-travail/ rapports-publications/ radiation/code-securite-35-procedures-securite-installation-utilisation-appareils. html.
[31]	Bazoma J, Dallou GB, Ondo Meye P, Bouka Biona C, Saïdou GH: Ben-Bolie, “Assessment of Organ and Effective Doses Received by Paediatric Patients Undergoing Computed Tomography Examinations in Three Hospitals in Brazzaville, Congo Republic: An Urgent Necessity for Regulatory Control,” Int. J. Sci. Res. Sci. Technol., vol. 8, no. 5, pp. 527–550, 2021.
[32]	IAEA: “Normes de sûreté de l’AIEA pour la protection des personnes et de l’environnement,” Vienne, 2017.