CT RADIATION EXPOSURE AND DIAGNOSTIC REFERENCE LEVEL ADHERENCE ACROSS KUWAIT'S PUBLIC HOSPITALS: A FIVE-YEAR ANALYSIS OF 100K EXAMINATIONS
Author(s)
Fatima Alshamali, BS1, Abdullah Alibrahim, PhD2;
1Kuwait University, Kuwait City, Kuwait, 2Kuwait University, Industrial & Management Systems Engineering, Kuwait City, Kuwait
1Kuwait University, Kuwait City, Kuwait, 2Kuwait University, Industrial & Management Systems Engineering, Kuwait City, Kuwait
OBJECTIVES: To quantify patient radiation exposure from computed tomography examinations across Kuwait's public hospital system and evaluate adherence to national diagnostic reference levels (DRLs), identifying demographic and institutional patterns of dose exceedance to inform radiation safety policy.
METHODS: Retrospective analysis (2018-2022) of CT dose data from DoseWatch systems across seven Ministry of Health hospitals (3 general, 4 specialized), encompassing 21 scanners. Dose-length product (DLP) served as the primary exposure metric. Examinations were classified into head, chest, and abdomen regions. DRL exceedance was determined by comparing individual DLP values against age-specific Kuwait thresholds across five age categories. Subgroup analyses examined variation by age, gender, hospital category, and year using descriptive statistics and 95% confidence intervals.
RESULTS: Among 101,624 examinations (83,603 patients), overall DRL exceedance rates were 18.5% (head), 25.8% (chest), and 27.5% (abdomen). General hospitals exhibited systematically higher exceedance than specialized hospitals across all regions. For infant chest CT, general hospitals recorded 72.5% exceedance (mean DLP 107 mGy·cm) versus 6.6% (21.2 mGy·cm) in specialized facilities. Pediatric patients showed paradoxically high exceedance despite lower absolute doses: children aged 5-10 demonstrated 78.7% exceedance for abdomen CT. Male patients received higher doses than females across all regions. The 248 unique examination names identified highlighted nomenclature heterogeneity complicating standardization.
CONCLUSIONS: This first large-scale CT dose evaluation in Kuwait reveals substantial institutional and demographic variation in DRL adherence. However, current DRLs are body-region rather than indication-specific, potentially overestimating unnecessary exposure. Findings support targeted protocol standardization in general hospitals, pediatric-focused optimization, and development of indication-specific reference levels for Kuwait's next DRL revision cycle.
METHODS: Retrospective analysis (2018-2022) of CT dose data from DoseWatch systems across seven Ministry of Health hospitals (3 general, 4 specialized), encompassing 21 scanners. Dose-length product (DLP) served as the primary exposure metric. Examinations were classified into head, chest, and abdomen regions. DRL exceedance was determined by comparing individual DLP values against age-specific Kuwait thresholds across five age categories. Subgroup analyses examined variation by age, gender, hospital category, and year using descriptive statistics and 95% confidence intervals.
RESULTS: Among 101,624 examinations (83,603 patients), overall DRL exceedance rates were 18.5% (head), 25.8% (chest), and 27.5% (abdomen). General hospitals exhibited systematically higher exceedance than specialized hospitals across all regions. For infant chest CT, general hospitals recorded 72.5% exceedance (mean DLP 107 mGy·cm) versus 6.6% (21.2 mGy·cm) in specialized facilities. Pediatric patients showed paradoxically high exceedance despite lower absolute doses: children aged 5-10 demonstrated 78.7% exceedance for abdomen CT. Male patients received higher doses than females across all regions. The 248 unique examination names identified highlighted nomenclature heterogeneity complicating standardization.
CONCLUSIONS: This first large-scale CT dose evaluation in Kuwait reveals substantial institutional and demographic variation in DRL adherence. However, current DRLs are body-region rather than indication-specific, potentially overestimating unnecessary exposure. Findings support targeted protocol standardization in general hospitals, pediatric-focused optimization, and development of indication-specific reference levels for Kuwait's next DRL revision cycle.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO196
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas