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This cross-sectional study included adult oncology patients undergoing trunk MSCT at two governmental hospitals in Gaza Strip; Al Shifa Medical Complex (SMC) and Al Aqsa Martyrs Hospital (AMH), using an adapted dose survey booklet. Data collected from July 2019 to March 2020 included patient characteristics, volumetric CT dose index (CTDI\n                    <jats:sub>vol<\/jats:sub>\n                    ) and dose length product (DLP). Descriptive, univariate and multivariate analyses identified key factors affecting radiation dose, and the coefficient of variation between scanner- and software-derived dose values was also determined. A total of 170 trunk CT examinations were analysed (57.1% SMC, 42.9% AMH). 72.94% were female; the mean age of the participants is 53.1\u2009\u00b1\u200915.8 years, and the mean body mass index was 30\u2009\u00b1\u20096.1. The estimated LDRLs for trunk CT were 13 mGy for CTDI\n                    <jats:sub>vol<\/jats:sub>\n                    and 1010.4 mGy\u00b7cm for DLP. There was notable variation between hospitals in CTDI\n                    <jats:sub>vol<\/jats:sub>\n                    and DLP (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). At SMC, factors such as tube current, peak kilovoltage, scan length, pitch and BMI significantly affected dose indices. In contrast, at AMH, the main influences were tube current and scan length. CTDI\n                    <jats:sub>vol<\/jats:sub>\n                    had a greater impact on DLP than scan length at both locations. LDRLs for trunk CT scans in the Gaza Strip were established and found to be generally comparable to international benchmarks. Notable variation in doses between hospitals indicates potential for improvement through standardising protocols, managing scan lengths and using techniques tailored to patient size.\n                  <\/jats:p>","DOI":"10.1007\/s12194-026-01053-x","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:34:22Z","timestamp":1777534462000},"page":"782-791","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishment of local diagnostic reference levels for trunk computed tomography examinations at governmental hospitals in the Gaza Strip: a cross-sectional study"],"prefix":"10.1007","volume":"19","author":[{"given":"Amjad","family":"Ayyad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Alajerami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Najim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam H.","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Khalis Abdul","family":"Karim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3896-2542","authenticated-orcid":false,"given":"Kinan","family":"Mokbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"22","key":"1053_CR1","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1056\/NEJMra072149","volume":"357","author":"DJ Brenner","year":"2007","unstructured":"Brenner DJ. 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Administrative approval was obtained from the Ministry of Health, State of Palestine (Human Resources Development Directorate; correspondence number 381554; 17 Oct 2019). Informed consent was obtained from all participants before participation. Declaration that all supporting documentation concerning ethical review and patient informed consent is available upon request.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}