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Peer-Reviewed Publication
Radiol Phys Technol2026;19(2):651-665.June 1, 2026Journal Article

Establishment of local diagnostic reference levels for planning CT in adult and pediatric radiotherapy patients in 18 Japanese university hospitals.

Hideki Obara1, Kiyokazu Sato2,3, Satoshi Abe4, Hiroki Katayama5, Takahiro Ushijima6, Takuro Okumura7, Yuki Yuasa8, Yoshinobu Shimohigashi9, Hironori Kojima10, Taka-Aki Hirose11, Mizuho Saito12, Takashi Iimori13, Masanobu Terui14
1Department of Radiology, Division of Medical Technology, Hirosaki University School of Medicine and Hospital, 53, Hon-cho, Hirosaki-shi, Aomori, 036-8563, Japan. obara@hirosaki-u.ac.jp.
2Department of Radiology, Division of Medical Technology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai-shi, Miyagi, 980-8574, Japan.
3Varian Medical Systems K.K. Gate City Ohsaki, 11-1, Ohsaki 1-Chome, Shinagawa-ku, Tokyo, 141-0032, Japan.
4Department of Radiology, Gunma University Graduate School of Medicine and Hospital, 3-39-15, Syowa-machi, Maebashi-shi, Gunma, 371-8511, Japan.
5Department of Radiology, Division of Medical Technology, Kagawa University School of Medicine and Hospital, 1750-1, Kida-gun, Miki-cho, Kagawa, 761-0793, Japan.
6Department of Radiology, Mie University School of Medicine and Hospital, 2-174, Edobashi, Tsu-shi, Mie, 514-8507, Japan.
7Division of Radiation Therapy, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima-shi, Hiroshima, 734-8551, Japan.
8Department of Radiological Technology, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube-shi, Yamaguchi, 755-8505, Japan.
9Department of Radiology, Division of Medical Technology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan.
10Department of Radiology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Ishikawa, Japan.
11Department of Radiology, Division of Medical Technology, Kyusyu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka-shi, Hakata, 812-8582, Japan.
12Department of Radiology, Division of Medical Technology, Hirosaki University School of Medicine and Hospital, 53, Hon-cho, Hirosaki-shi, Aomori, 036-8563, Japan.
13Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan.
14Central Radiology Division, Akita University Hospital, 44-2, Hasunuma, Hiroomote-aza, Akita-shi, Akita, 010-8543, Japan.
PubMed DOI

Abstract

Planning computed tomography (CT) for radiotherapy is essential for accurate treatment delivery but also contributes to patient radiation exposure. Therefore, diagnostic reference levels (DRLs) are recommended to optimize imaging doses. However, national DRLs (NDRLs) for planning CT in Japan have only recently been introduced. The aim of this study was to establish local diagnostic reference level…

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