{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T13:43:15Z","timestamp":1792330995394,"version":"4.4.0"},"reference-count":24,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejradiology.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Radiology"],"published-print":{"date-parts":[[2023,12]]},"DOI":"10.1016\/j.ejrad.2023.111191","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:51:46Z","timestamp":1699577506000},"page":"111191","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"special_numbering":"C","title":["Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study"],"prefix":"10.1016","volume":"169","author":[{"given":"M\u00f4nica","family":"Oliveira Bernardo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Karout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1vio","family":"Morgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Ebrahimian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alair","family":"Sarmet Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Amorim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilton","family":"Muniz Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Moscatelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valdair","family":"Francisco Muglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique","family":"Schroeder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Moulin Sales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renan","family":"Gandolpho Henschel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Giovanni Valese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Kiipper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Publio","family":"Cesar Cavalcanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronaldo","family":"Lucena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago","family":"Jornada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valnir","family":"de Paula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Zago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Varella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Anes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"M\u00e1rcio Alves Pinheiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz","family":"Cla\u00fadio de Moura Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Santana de Melo Tapajos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Antonio de Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Applegate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciano","family":"Paulo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Roberto Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ejrad.2023.111191_b0005","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1109\/RBME.2020.2990959","article-title":"The role of imaging in the detection and management of COVID-19: a review","volume":"14","author":"Dong","year":"2020","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"10.1016\/j.ejrad.2023.111191_b0010","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1093\/rpd\/ncab121","article-title":"Practical challenges with imaging COVID-19 in Brazil: Mitigation in and beyond the pandemic","volume":"195","author":"Bernardo","year":"2021","journal-title":"Radiat. Prot. Dosim."},{"key":"10.1016\/j.ejrad.2023.111191_b0015","doi-asserted-by":"crossref","first-page":"7022","DOI":"10.1007\/s00330-021-07753-9","article-title":"Comparison of 12 surrogates to characterize CT radiation risk across a clinical population","volume":"31","author":"Ria","year":"2021","journal-title":"Eur. Radiol."},{"key":"10.1016\/j.ejrad.2023.111191_b0020","doi-asserted-by":"crossref","unstructured":"S. Simpson, F.U. Kay, S. Abbara et al., Radiological Society of North America expert consensus statement on reporting chest CT findings related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. J. Thoracic Imaging, 2020.","DOI":"10.1148\/ryct.2020200152"},{"key":"10.1016\/j.ejrad.2023.111191_b0025","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.2020203453","article-title":"Variations in CT utilization, protocols, and radiation doses in COVID-19 pneumonia: results from 28 countries in the IAEA study","author":"Homayounieh","year":"2021","journal-title":"Radiology"},{"key":"10.1016\/j.ejrad.2023.111191_b0030","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1148\/radiol.13122349","article-title":"Iterative reconstruction algorithm for CT: can radiation dose be decreased while low-contrast detectability is preserved?","volume":"269","author":"Schindera","year":"2013","journal-title":"Radiology"},{"key":"10.1016\/j.ejrad.2023.111191_b0035","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1148\/radiol.2303021726","article-title":"Strategies for CT radiation dose optimization","volume":"230","author":"Kalra","year":"2004","journal-title":"Radiology"},{"key":"10.1016\/j.ejrad.2023.111191_b0040","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13244-022-01180-0","article-title":"Impact of a radiological protection campaign in emergency paediatric radiology: a multicentric observational study in Brazil","volume":"13","author":"Oliveira Bernardo","year":"2022","journal-title":"Insights Imaging"},{"key":"10.1016\/j.ejrad.2023.111191_b0045","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0146645317717209","article-title":"ICRP publication 135: diagnostic reference levels in medical imaging","volume":"46","author":"Va\u00f1\u00f3","year":"2017","journal-title":"Ann. ICRP"},{"key":"10.1016\/j.ejrad.2023.111191_b0050","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13244-022-01180-0","article-title":"Impact of a radiological protection campaign in emergency paediatric radiology: a multicentric observational study in Brazil","volume":"13","author":"Oliveira Bernardo","year":"2022","journal-title":"Insights Imaging"},{"key":"10.1016\/j.ejrad.2023.111191_b0055","doi-asserted-by":"crossref","DOI":"10.1016\/j.radphyschem.2021.109888","article-title":"Poor practice and governance in Lebanese national diagnostic reference levels of adult head and body computed tomography: a nationwide study","volume":"192","author":"Karout","year":"2022","journal-title":"Radiat. Phys. Chem."},{"key":"10.1016\/j.ejrad.2023.111191_b0060","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1590\/S1020-49892009000200001","article-title":"Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil","volume":"25","author":"Freitas","year":"2009","journal-title":"Rev. Panam. Salud Publica"},{"key":"10.1016\/j.ejrad.2023.111191_b0065","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1007\/s00330-021-08266-1","article-title":"Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry","volume":"32","author":"Bos","year":"2022","journal-title":"Eur. Radiol."},{"key":"10.1016\/j.ejrad.2023.111191_b0070","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1148\/radiol.2017161911","article-title":"US diagnostic reference levels and achievable doses for 10 adult CT examinations","volume":"284","author":"Kanal","year":"2017","journal-title":"Radiology"},{"key":"10.1016\/j.ejrad.2023.111191_b0075","unstructured":"NCRP NCRP Report No. 172, Reference Levels and Achievable Doses in Medical and Dental Imaging: Recommendations for the United States Available via https:\/\/ncrponline.org\/publications\/reports\/ncrp-report-172\/."},{"key":"10.1016\/j.ejrad.2023.111191_b0080","unstructured":"C. Clement, N. HAMADA, Diagnostic Reference Levels in Medical Imaging 11. Annals of the ICRP 3:4, 2016."},{"key":"10.1016\/j.ejrad.2023.111191_b0085","unstructured":"J. Damilakis, G. Frija, European Study on Clinical Diagnostic Reference Levels for X-ray Medical Imaging (EUCLID). European Congress of Radiology-EuroSafe Imaging 2019, 2019."},{"key":"10.1016\/j.ejrad.2023.111191_b0090","doi-asserted-by":"crossref","DOI":"10.2147\/COPD.S141295","article-title":"Comparison of world health organization and Asia-Pacific body mass index classifications in COPD patients","author":"Lim","year":"2017","journal-title":"Int. J. Chronic Obstruct. Pulmonary"},{"key":"10.1016\/j.ejrad.2023.111191_b0095","doi-asserted-by":"crossref","unstructured":"Expert Panel on the Identification E, Overweight To, Adults Oi, Executive Summary of the Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Archives of Internal Medicine 158 (1998) 1855\u20131867.","DOI":"10.1001\/archinte.158.17.1855"},{"key":"10.1016\/j.ejrad.2023.111191_b0100","unstructured":"Agency UHS (2022) National Diagnostic Reference Levels (NDRLs) from 13 October 2022. Available via https:\/\/www.gov.uk\/government\/publications\/diagnostic-radiology-national-diagnostic-reference-levels-ndrls\/ndrl."},{"key":"10.1016\/j.ejrad.2023.111191_b0105","unstructured":"ACR\u2013AAPM\u2013SPR, Practice parameter for diagnostic reference levels and achievable doses in medical x-ray imaging. ACR\u2013AAPM\u2013SPR, 2018."},{"key":"10.1016\/j.ejrad.2023.111191_b0110","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13244-020-00899-y","article-title":"Diagnostic Reference Levels based on clinical indications in computed tomography: a literature review","volume":"11","author":"Paulo","year":"2020","journal-title":"Insights Imaging"},{"key":"10.1016\/j.ejrad.2023.111191_b0115","doi-asserted-by":"crossref","unstructured":"L. Narciso, N. Lima, C. Dartora, A. Marques da Silva, A contribution to the establishment of diagnostic reference levels in computed tomography in BrazilWorld Congress on Medical Physics and Biomedical Engineering, June 7-12, 2015, Toronto, Canada. Springer, 2015, pp 737-740.","DOI":"10.1007\/978-3-319-19387-8_181"},{"key":"10.1016\/j.ejrad.2023.111191_b0120","unstructured":"American College of Radiology (ACR) Dose Index Registry. Available via https:\/\/www.acr.org\/Practice-Management-Quality-Informatics\/Registries\/Dose-Index-Registry."}],"container-title":["European Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0720048X23005053?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0720048X23005053?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T07:39:10Z","timestamp":1759995550000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0720048X23005053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":24,"alternative-id":["S0720048X23005053"],"URL":"https:\/\/doi.org\/10.1016\/j.ejrad.2023.111191","relation":{},"ISSN":["0720-048X"],"issn-type":[{"value":"0720-048X","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study","name":"articletitle","label":"Article Title"},{"value":"European Journal of Radiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejrad.2023.111191","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"111191"}}