Article

Establishment of local diagnostic reference level for computed tomography angiography in Morocco

¹ Hassan First University of Settat, Laboratory health sciences and technologies, Higher Institute of Health Sciences, Settat, Morocco
² Sciences and Engineering of Biomedicals, Biophysics and Health Laboratory, Higher Institute of Health Sciences, Hassan First University, Settat 26000, Morocco
³ Physical Sciences and Engineering, Innovative Research and Applied Physics (IRAP), Faculty of Sciences, Moulay Ismail University, Meknes, Morocco
⁴ LPHE-Modeling and Simulations, Faculty of Science, Mohammed V University in Rabat, Rabat, Morocco
⁵ Emergency Radiology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
⁶ LIS, Faculty of science Ain Chock, Casablanca 20100, Morocco

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Received: 22 December 2024
Accepted: 18 August 2025

Abstract

Objective: To establish local diagnostic reference levels (LDRLs) for computed tomography angiography (CTA) examinations in Morocco. Methods: Data were collected from 2283 adult patients undergoing CTA scans across four hospitals in Morocco, covering examinations of the upper limb, brain, carotid arteries, pulmonary arteries, abdominal aorta, total aorta, and lower limb. CTDI_vol and DLP were recorded and analyzed. The 75^th percentile values were determined as local DRLs. Results: For Hospital A, the LDRLs (CTDI_vol and DLP) for upper limb, brain CTA, carotids, pulmonary arteries, abdominal aorta, total aorta, and lower limb were 16.05 mGy and 1059.81 mGy × cm, 26.1 mGy and 1370.48 mGy × cm, 13.95 mGy and 1303.85 mGy × cm, 3.18 mGy and 321.38 mGy × cm, 9.69 mGy and 1453.79 mGy × cm, 5.12 mGy and 1346.47 mGy × cm, and 7.49 mGy and 600.3 mGy × cm, respectively. Hospital B had higher DRLs due to more scan phases. Hospital C’s LDRLs for carotids, pulmonary arteries, abdominal aorta, total aorta, and lower limb were 9.07 mGy and 819.49 mGy × cm, 11.52 mGy and 487.56 mGy × cm, 9.41 mGy and 1018.17 mGy × cm, 10.74 mGy and 1860.74 mGy × cm, and 9.4 mGy and 860.98 mGy × cm, respectively. Hospital D, the LDRLs for carotids, pulmonary arteries, and lower limb were 5.98 mGy and 596 mGy x cm, 3.87 mGy and 357 mGy × cm, and 6.53 mGy and 724 mGy × cm, respectively. Conclusion: Moroccan LDRLs generally have lower CTDI_vol but higher DLP values, primarily due to more scan phases used. More efforts are needed to optimize radiation dose during vascular CT examinations.