{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:49:11Z","timestamp":1775735351103,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Chest and abdomen radiographs are the most common radiograph examinations conducted in the Dubai Health sector, with both involving exposure to several radiosensitive organs. Diagnostic reference levels (DRLs) are accepted as an effective safety, optimization, and auditing tool in clinical practice. The present work aims to establish a comprehensive projection and weight-based structured DRL system that allows one to confidently highlight healthcare centers in need of urgent action. The data of a total of 5474 adult males and non-pregnant females who underwent chest and abdomen radiography examinations in five different healthcare centers were collected and retrospectively analyzed. The typical DRL (TDRL) for each healthcare center was established and defined per projection (chest: posterior\u2013anterior (PA), anterior\u2013posterior (AP) and lateral (LAT); abdomen: erect and supine) for a weight band (60\u201380 kg) and for the whole data (no weight band). Local DRL (LDRL) values were established per project for the selected radiograph for the whole data (no weight band) and the 60\u201380 kg population. Chest radiography data from 1755 (60\u201380 kg) images were used to build this comprehensive DRL system (PA: 1471, AP: 252, and LAT: 32). Similarly, 611 (60\u201380 kg) abdomen radiographs were used to establish a DRL system (erect: 286 and supine: 325). The LDRL values defined per chest and abdomen projection for the weight band group (60\u201380 kg) were as follows: chest\u20140.51 PA, 2.46 AP, and 2.13 LAT dGy\u00b7cm2; abdomen\u20148.08 for erect and 5.95 for supine dGy\u00b7cm2. The LDRL defined per abdomen projection for the 60\u201380 kg weight band highlighted at least one healthcare center in need of optimization. Such a system is efficient, easy to use, and very effective clinically.<\/jats:p>","DOI":"10.3390\/jimaging11010021","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T04:01:52Z","timestamp":1736740912000},"page":"21","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Typical and Local Diagnostic Reference Levels for Chest and Abdomen Radiography Examinations in Dubai Health Sector"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4485-4775","authenticated-orcid":false,"given":"Entesar Z.","family":"Dalah","sequence":"first","affiliation":[{"name":"Central Diagnostic Imaging Department, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"},{"name":"College of Medicine, Mohammed Bin Rashid University, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maitha M. Al","family":"Zarooni","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Rashid Hospital, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faryal Y.","family":"Binismail","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Dubai Hospital, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashim A.","family":"Beevi","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Hatta Hospital, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Siraj","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, PHC Hospital, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subrahmanian","family":"Pottybindu","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Latifa Hospital, Dubai Health, Dubai P.O. Box 2727, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1259\/bjr\/01948454","article-title":"Cancer risks from diagnostic radiology","volume":"81","author":"Hall","year":"2014","journal-title":"Br. J. Radiol."},{"key":"ref_2","unstructured":"(2018). Radiation Protection and Safety in Medical Uses of Ionizing Radiation (Standard No. SSG-46)."},{"key":"ref_3","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":"Miller","year":"2017","journal-title":"Ann. ICRP"},{"key":"ref_4","unstructured":"Lau, L., and Perez, M. Global Initiative on Radiation Safety in Healthcare Settings. Technical Meeting Report. 15th to 17th December 2008, WHO."},{"key":"ref_5","unstructured":"FANR (2012). FANR-RG-007. Regulatory Guide Radiation Safety Version 0, FANR."},{"key":"ref_6","unstructured":"FANR (2018). FANR-REG-24. Basic Safety Standards for Facilities and Activities Involving Ionizing Radiation Other than in Nuclear Facilities; Version 1:1-63, FANR."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Dalah, E.Z., AlKaabi, M.K., Al-Awadhi, H.A., and Antony, N.A. (2024). Screening Mammography Diagnostic Reference Level System According to Compressed Breast Thickness: Dubai Health. J. Imaging, 10.","DOI":"10.3390\/jimaging10080188"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13244-023-01369-x","article-title":"How to establish and use local diagnostic reference levels: An ESR EuroSafe imaging expert statement","volume":"14","author":"Damilakis","year":"2023","journal-title":"Insight Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ejmp.2020.09.015","article-title":"Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives","volume":"79","author":"Tsapaki","year":"2020","journal-title":"Phys. Medica"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"ICRP 105 (2007). Radiation protection in medicine. Ann. ICRP, 37, 1.","DOI":"10.1016\/j.icrp.2008.07.001"},{"key":"ref_11","unstructured":"ICRP 103 (2007). The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann. ICRP, 37, 1\u2013332."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.radi.2023.03.005","article-title":"Potentials of additional copper filtration on radiation dose and image quality for adults underwent digital chest X-ray imaging in Dubai Health Authority\u2014UAE","volume":"29","author":"Siraj","year":"2023","journal-title":"Radiography"},{"key":"ref_13","unstructured":"Qaelum, N.V. (2019). Dose Patient Radiation Dose Monitoring System User Manual, Version 19.02; Qaelum."},{"key":"ref_14","first-page":"e15005","article-title":"Patient-based dose audit for common radiographic examinations with digital radiology systems: A retrospective cross-sectional study","volume":"13","author":"Alshamrani","year":"2021","journal-title":"Cureus"},{"key":"ref_15","unstructured":"Health Information and Quality Authority (2021). National Diagnostic Reference Levels (DRLs) for General Radiography, Mammography and DXA Scanning, Health Information and Quality Authority."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ejrad.2019.02.015","article-title":"Diagnostic reference levels for conventional radiography and fluoroscopy in Austria: Results and updated national diagnostic reference levels derived from a nationwide survey","volume":"113","author":"Wachabauer","year":"2019","journal-title":"Eur. J. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ejrad.2017.11.002","article-title":"Using diagnostic reference levels to evaluate the improvement of patient dose optimization and the influence of recent technologies in radiography and computed tomography","volume":"98","author":"Roch","year":"2018","journal-title":"Eur. J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1120\/jacmp.v17i6.6011","article-title":"Evaluation of dose-area product of common radiographic examinations towards estimating preliminary diagnostic reference levels (PDRLs) in Southwestern Nigeria","volume":"17","author":"Jibiri","year":"2016","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_19","unstructured":"Hart, D., Hillier, M.C., and Shrimpton, P.C. (2010). Doses to Patients from Radiographic and Fluoroscopic X-ray Imaging Procedures in the UK 2010 Review. HPA-CRCE-03, Center for Radiation, Chemical and Environmental Hazards (HPA-CRCE)."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1016\/j.radi.2019.10.013","article-title":"A multi institutional comparison of imaging dose and technique protocols for neonatal chest radiography","volume":"26","author":"Gunn","year":"2020","journal-title":"Radiography"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"110477","DOI":"10.1016\/j.apradiso.2022.110477","article-title":"Supine and erect abdominal radiography: A coparison of radiation dose and image quality","volume":"190","author":"Alzyoud","year":"2022","journal-title":"Appl. Radiat. Isot."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/rpd\/ncab067","article-title":"Comparison of conventional hand examination on six optimized DR systems","volume":"194","author":"Precht","year":"2021","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1177\/02841851221140210","article-title":"Comparing image quality of fibe breast tomosynthesis systems based on radiologists review of phantom data","volume":"64","author":"Sundell","year":"2023","journal-title":"Acta Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5919","DOI":"10.1007\/s00402-022-04674-0","article-title":"Radiostereometric analysis: Comparison of radiation dose and precision in digital and computed radiography","volume":"143","author":"Jorgensen","year":"2023","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.carj.2011.02.004","article-title":"Local diagnostic reference levels for typical radiographic procedures","volume":"63","author":"Tonkopi","year":"2012","journal-title":"Candian Assoc. Radiol. J."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Martin, C.J. (2007). Optimization in general radiography. Biomed. Imaging Interv. J., 3.","DOI":"10.2349\/biij.3.2.e18"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jmir.2008.11.002","article-title":"Nonselective filters offer important dose-reduction potential in radiological examination of the paediatric pelvis","volume":"40","author":"Butler","year":"2009","journal-title":"J. Med. Imaging Radiat. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s43055-023-01003-2","article-title":"Evaluation of patient radiation doses using DAP meter in diagnostic radiology procedures in Birjand, Iran","volume":"54","author":"Zarghani","year":"2023","journal-title":"Egypt. J. Radiol. Nucl. Med."}],"container-title":["Journal of Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/1\/21\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:27:32Z","timestamp":1759919252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/1\/21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,13]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jimaging11010021"],"URL":"https:\/\/doi.org\/10.3390\/jimaging11010021","relation":{},"ISSN":["2313-433X"],"issn-type":[{"value":"2313-433X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,13]]}}}