NIGERIAN RADIOGRAPHERS OBLIGATION TO DIAGNOSTIC REFERENCE LEVELS (DRLs) IN MEDICAL IMAGING

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Rad. Tom Adejoh (Ph.D)

Abstract

Background: Diagnostic reference levels (DRLs) help to identify unusually high dose levels in medical procedures involving radiation. This will subsequently, stimulate quality control. There are legislations and guidelines requiring Member States of European Union to adopt DRLs. While about 72% of European countries as well as the United States have complied, and with subsequent reviews demonstrating significant dose reductions (16% – 30%), no evidences link any African country to replicating the same.


Objective: This work briefly reviewed the progress of Nigeria with regards to diagnostic reference levels (DRLs) and with particular attention to efforts by radiographers.


Methods: Google search was made with keywords of 'diagnostic reference levels' as well as 'radiation dose in Nigeria.' Over forty works were retrieved but only twentytwo which had specific relevance to the focus of the review were archived and read. The works were subsequently scrutinized to piece together the trend of DRLs globally, and locally.


Results: Publications on x-ray, mammography, fluoroscopy and computed tomography dose abound in Nigeria. Doses had wide variations in all modalities. There were no accessible evidence to indicate that any regulatory agency in Nigeria had keyed into the imperative of dose investigation, monitoring and reporting.


Conclusion: In conclusion, diagnostic reference levels in x-ray, mammography and computed tomography have been recommended by independent researchers in Nigeria. Regulatory agencies are urged to summon the will to give guidelines on implementation of these DRLs in order to improve optimization of protection for patients. 

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Adejoh , T. (2025). NIGERIAN RADIOGRAPHERS OBLIGATION TO DIAGNOSTIC REFERENCE LEVELS (DRLs) IN MEDICAL IMAGING. Journal of Radiography and Radiation Sciences, 34(1), 01-06. https://doi.org/10.82547/jrrs.vol34no1.34

References

1. Herbst K, Littlejohns P, Rawlinson J, Collinson M and Wyatt JC. Evaluating computerized health information systems: hardware, software and humanware: experiences from the Northern Province, South Africa. Journal of Public Health Medicine, 1999; 21 (3): 305 –310

2. Adejoh T, Nzotta CC, Umeh EO, Aronu ME, Dambele MY. Head computed tomography protocol audit and correction in two tertiary health institutions in Anambra State of Nigeria. West African Journal of Radiology, 2017; 24:157- 161

3. Seibert JA. Tradeoffs between image quality and dose. Pediatr Radiol., 2004;34 Suppl 3:S183-95; doi: 10.1007/s00247-004-1268-7.

4. Hamada N and Fujimichi Y. Classification of radiation effects for dose limitation purposes: history, current situation and future prospects.

J Radiat Res., 2014; 55(4): 629–640. doi:10.1093/jrr/rru019

5. Oakley PA and Harrison DE. Death of the ALARA radiation protection principle as used in the medical sector. Dose Response., 2020; 18(2): doi: 10.1177/1559325820921641

6. ICRP. The 2007 recommendations of the international commission on radiological protection. ICRP publication 103 Ann. ICRP, 2007; 37: 1–332

7. Kyung-Hyun Do. General principles of radiation protection in fields of diagnostic medical exposure. J Korean Med Sci. 2016; 3 1 ( S u p p l 1 ) : S 6 – S 9 . d o i : 10.3346/jkms.2016.31.S1.S6

8. Ekpo E, Adejoh T, Akwo J, Onwujekwe EC, Ali AA, Abba M, Adesina K, Omiyi D, Chiegwu HU. Diagnostic reference levels for common

computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey. Journal of Radiological Protection,

2018; 38: 525 – 535 https://doi.org/10.1088/1361-6498/aaaaf8

9. Meghzifenea A, Dance DR, McLeana D, Kramer H-M. Dosimetry in diagnostic radiology. European Journal of Radiology, 2010; 76: 11 – 14

10. Pradhan AS. Evolution of dosimetric quantities of International Commission on Radiological Protection (ICRP): Impact of the forthcoming

recommendations. J Med Phys, 2007: 32: 89 -91

11. Vassileva J and Rehani M. Diagnostic reference levels. American Journal of Roentgenology; 2015; 204: W1-W3. 10.2214/AJR.14.12794

12. Vano E and Soto JMF. Patient dose management in digital radiography. Biomed Imaging Interv J. 2007; 3(2): e26.doi:10.2349/biij.3.2.e26

13. Brink JA and Miller DL. US nationaldiagnostic reference levels: closing the gap Radiology, 2015; 277: 3 – 6

14. Meyer S, Groenewald WA and Pitcher RD. Diagnostic reference levels in low- and middleincome countries: early ''ALARAm'' bells?

Acta Radiologica 2017, 58(4) 442–448 DOI: 10.1177/0284185116658681

15. Adejoh T, Nzotta CC. Head computed tomography: dose output and relationship with anthropo - technical parameters. West African

Journal of Radiology, 2016; 23 (2):113 – 117

16. Joseph DZ, Nzotta CC, Mohammed SU, Ameh PO, Njoku G, Malgwi FD, Moi Alhamdu S, Shem SL. Establishment of Local Diagnostic Reference Levels (DRLS) For Radiography Examinations in North Eastern Nigeria. Science World Journal, 2017;12(4):51-57

17. Joseph DZ, Nzotta CC, Skam JD, Umar MS, Musa DY. Diagnostic reference levels for mammography examinations in North Eastern

Nigeria.Afr J Med Health Sci 2018; 17: 54 – 59

18. Donald ML, Deukwoo K, and Grant BH. Reference levels for patient radiation doses in interventional radiology: proposed initial values for U.S. practice. Radiology, 2009; 253 (3): 753 – 764

19. Adejoh T, Onwujekwe EC, Abba M, Ali AM, Imo AS, Nzotta CC, Chiegwu HU. Computed tomography scanner census and adult head

dose in Nigeria. The Egyptian Journal of Radiology and Nuclear Medicine, 2018; 49: 66–70

20. Holmberg O, Malone J, Rehani M, McLean D, Czarwinski R. Current issues and actions in radiation protection of patients. European

Journal of Radiology, 2010; 76(1):15-19

21. Ekpo E, Adejoh T, Akwa EE. Dose benchmarks for paediatric head computed tomography (CT) examinations in Nigeria. Radiation Protection Dosimetry, 2019; 185 (4): 464 - 471

22. Paulo G, Damilakis J, Tsapaki V, Schegerer AA, Repussard J, Jaschke W, Frija G and European Society of Radiology. Diagnostic Reference Levels based on clinical indications in computed tomography: a literature review. Insights into Imaging, 2020; 11:96 https://doi.org/10.1186/s13244-020-00899-y

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