{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:01:39Z","timestamp":1773025299305,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":77,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Biomedical Imaging"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Many diagnostic reference levels (DRLs) in computed tomography (CT) imaging are based mainly on anatomical locations and often overlook variations in radiation exposure due to different clinical indications. While indication\u2010based DRLs, derived from dose descriptors like volume\u2010weighted CT dose index (CTDI\n                    <jats:sub>vol<\/jats:sub>\n                    ) and dose length product (DLP), are recommended for optimising patient radiation exposure, many studies still use anatomical\u2010based DRL values. This study is aimed at quantifying the differences between anatomical and indication\u2010based DRL values in head CT imaging and assessing its implications for radiation dose management. This will support the narrative when explaining the distinction between indication\u2010based DRLs and anatomical DRLs for patients\u2019 dose management.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Employing a retrospective quantitative study design, we developed and compared anatomical and common indication\u2010based DRL values using a dataset of head CT scans with similar characteristics. The indications included in the study were brain tumor\/intracranial space\u2010occupying lesion (ISOL), head injury\/trauma, stroke, and anatomical examinations. Data analysis was conducted using SPSS Version 29.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The findings suggest that using anatomical\u2010based DLP DRL values for CT head examinations leads to underestimations in the median, 25th percentile, and 75th percentile values of head injury\/trauma by 20.2%, 30.0%, and 14.5% in single\u2010phase CT head procedures. Conversely, for the entire examination, using anatomical\u2010based DLP DRL as a benchmark for CT stroke DRL overestimates median, 25th percentile, and 75th percentile values by 18.3%, 23.9%, and 13.5%. Brain tumor\/ISOL DL\n                    <jats:italic>P<\/jats:italic>\n                    values are underestimated by 62.6%, 60.4%, and 71.8%, respectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The study highlights that using anatomical DLP DRL values for specific indications in head CT scans can lead to underestimated or overestimated DL\n                    <jats:italic>P<\/jats:italic>\n                    values, making them less reliable for radiation management compared to indication\u2010based DRLs. Therefore, it is imperative to promote the establishment and use of indication\u2010based DRLs for more accurate dose management in CT imaging.\n                  <\/jats:p>","DOI":"10.1155\/ijbi\/6464273","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:48:21Z","timestamp":1742431701000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Anatomical and Indication\u2010Based Diagnostic Reference Levels (DRLs) in Head CT Imaging: Implications for Radiation Dose Management"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0477-640X","authenticated-orcid":false,"given":"Benard","family":"Ohene-Botwe","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0371-3597","authenticated-orcid":false,"given":"Samuel","family":"Anim-Sampong","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8485-8593","authenticated-orcid":false,"given":"Robert","family":"Saizi","sequence":"additional","affiliation":[]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.101808"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radphyschem.2022.110735"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-014-0974-z"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40886-016-0019-4"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000696"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJMP.2021.03.012"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0146645317717209"},{"key":"e_1_2_9_8_2","unstructured":"American College of Radiology ACR-AAPM-SPR practice parameter for diagnostic reference levels and achievable doses in medical x-ray imaging 2018 https:\/\/www.acr.org\/-\/media\/ACR\/Files\/Practice-Parameters\/diag-ref-levels.pdf."},{"key":"e_1_2_9_9_2","unstructured":"International Atomic Energy Agency Diagnostic reference levels (DRLs) in medical imaging 2023 April 2023 https:\/\/www.iaea.org\/resources\/rpop\/health-professionals\/nuclear-medicine\/diagnostic-nuclear-medicine\/diagnostic-reference-levels-in-medical-imaging."},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13244-016-0538-x"},{"key":"e_1_2_9_11_2","unstructured":"DamilakisJ. 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