The Historical Development of Reference Doses in Diagnostic Radiology

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Abstract
National surveys of patient doses from X ray examinations in Europe and the USA since the 1950s have demonstrated wide variations in doses between hospitals and the need for quantitative guidance on patient exposure. Subsequent national advice on patient protection in the USA and UK included dosimetry protocols and reference doses in order to prompt local critical review of potentially poor practice. The concept of investigation levels for diagnostic medical exposures was first proposed by ICRP in its 1990 recommendations and further developed into diagnostic reference levels in ICRP Publication 73. At the European level, the Medical Exposure Directive of 30 June 1997 requires Member States to promote the establishment of diagnostic reference levels and for national regulations implementing this requirement to be in place by May 2000. Meanwhile, reference dose values have been incorporated into European Guidelines on Quality Criteria for Diagnostic Radiographic Images and for Computed Tomography and are being developed for Paediatric Radiology. The development of reference doses in Europe over the past decade is reviewed, appropriate dose quantities described and the philosophy behind the selection of suitable reference dose values discussed.

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