Optimization of radiation protection using diagnostic reference values: current approaches and future directions

Diagnostic reference levels (DRLs) were introduced as a tool to optimize radiation protection in medical imaging. Conditions for dose assessment have evolved significantly. This study explores how effectively the current DRL system functions and whether it requires adjustment. The analysis focuses on the national DRL system in Sweden and includes European projects and guidelines for reference. The variability in typical doses has decreased. National DRL values have been lowered; however, values in nuclear medicine have seen minimal change. These developments present challenges in revising the values. The increased availability of digital data offers both opportunities and challenges. The DRL system may include specific indications, larger patient cohorts, and consideration of patient size. To remain relevant, the DRL system must be updated to reflect changes in clinical practice. The integration of image quality assessment into the DRL framework is one critical area that requires further development.