DVTA News

The EUCLID (European Study on Clinical Diagnostic Reference Levels for X-ray Medical Imaging) project, a 33-month European Commission tender project run by the European Society of Radiology which began in August 2017, has come to a successful conclusion with the publication of European Commission Radiation Protection series publication 195: European study on clinical diagnostic reference levels for X-ray medical imaging.

The concept of Diagnostic Reference Levels (DRLs) has been introduced to highlight unusually high or low patient radiation doses from medical imaging examinations and procedures and their establishment and use is required in the European Council Directive 2013/59/Euratom – Basic Safety Standards (BSS).

Previous publications highlighted the importance of establishing DRLs for high-dose medical examinations, in particular computed tomography (CT) and interventional radiology (IR), but did not provide examples of DRLs for these procedures, both of which produce relatively high exposures to radiation. Additionally, DRLs have previously largely been specified in relation to the body region (e.g., abdomen) without specification of what kind of procedure is being conducted (e.g. appendicitis), which can have a significant influence on what radiation dose is necessary to correctly diagnose the patient. The European Commission approved the EUCLID project (European Study on Clinical Diagnostic Reference Levels for X-ray Medical Imaging) with the aim of starting the process of establishing clinical-indication specific DRLs for the most important, from a radiation protection perspective, X-ray imaging tasks in Europe. The precise list of the clinical indications for CT and IR which were chosen for study is available here.

The EUCLID project established a network of hospitals covering 14 countries across Europe to work on the project and supply data on radiation doses. A highly productive workshop was held in Luxembourg in December 2019 to discuss the project’s results, differing perspectives on DRLs, and how DRLs will affect clinical practice. The workshop included presentations from international experts on designing surveys with the goal of establishing DRLs; implementing DRLs; optimising patient radiation protection through DRLs; and, differing regional perspectives. Following this workshop, analysis of the data collected during the project was concluded.

The project’s final outcomes have been published as European Commission Radiation Protection series publication 195: European study on clinical diagnostic reference levels for X-ray medical imaging. The European Society of Radiology is proud to have contributed to ensuring patient safety around Europe by helping establish these new DRLs.

Further academic publications on the outcomes of the project can be found on the EUCLID project website:

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