The diagnostic reference levels (DRLs) for the 10 most common adult CT exams performed in the U.S. match those of many other countries, according to an article published online January 19 in the Journal of the American College of Radiology.
In a follow-up study, first author Priscilla Butler and colleagues compared U.S. DRLs previously reported by Kanal et al with DRLs from different countries, including Japan, Australia, Canada, several individual countries in the European Union, and the European Union as a whole. The researchers found the DRLs to be similar among these nations.
The U.S. DRLs never ranked as the highest for any of the primary adult CT exams studied, and the country's average CT dose index volume (CTDIvol) was lowest among all countries for noncontrast head CT exams.



















![Images show the pectoralis muscles of a healthy male individual who never smoked (age, 66 years; height, 178 cm; body mass index [BMI, calculated as weight in kilograms divided by height in meters squared], 28.4; number of cigarette pack-years, 0; forced expiratory volume in 1 second [FEV1], 97.6% predicted; FEV1: forced vital capacity [FVC] ratio, 0.71; pectoralis muscle area [PMA], 59.4 cm2; pectoralis muscle volume [PMV], 764 cm3) and a male individual with a smoking history and chronic obstructive pulmonary disorder (COPD) (age, 66 years; height, 178 cm; BMI, 27.5; number of cigarette pack-years, 43.2, FEV1, 48% predicted; FEV1:FVC, 0.56; PMA, 35 cm2; PMV, 480.8 cm3) from the Canadian Cohort Obstructive Lung Disease (i.e., CanCOLD) study. The CT image is shown in the axial plane. The PMV is automatically extracted using the developed deep learning model and overlayed onto the lungs for visual clarity.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/03/genkin.25LqljVF0y.jpg?auto=format%2Ccompress&crop=focalpoint&fit=crop&h=112&q=70&w=112)