Optimization and image quality in CT studies: application of DRLs based on clinical indication

The use of ionizing radiation in computed tomography (CT) has significantly enhanced diagnostic accuracy and clinical decision-making. However, optimizing CT protocols is crucial to balance the diagnostic benefits with potential radiation risks, particularly for vulnerable populations. Diagnostic Reference Levels (DRLs), introduced to guide dose optimization, highlight variations in dose indices due to local protocol differences rather than patient or equipment characteristics. This underscores the importance of standardizing technical parameters to ensure consistent image quality and minimize dose variability. Recent advancements, including iterative reconstruction algorithms and artificial intelligence, offer promising avenues for dose reduction without compromising diagnostic value. Effective optimization strategies require a multidisciplinary approach, incorporating continuous protocol evaluation, adherence to quality assurance programs, and clinical audits. Standardized DRLs tailored to clinical indications further enhance imaging practices, reducing variability and fostering safer, more effective patient care. The purpose of this article is to demonstrate, through a review of the literature and recent papers, applied to clinical practice, the role of diagnostic reference levels (DRLs) in CT optimization and image’s quality.