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The recent European Council Directive 2013/59/EURATOM requires the establishment of diagnostic reference levels (DRLs) to optimise radiation dose in diagnostic and interventional radiology procedures. At the time this directive was enacted, just a few European countries had already set paediatric DRLs and many of these were outdated. For this reason, the European Commission launched a project addressing European Guidelines on Diagnostic Reference Levels for Paediatric Imaging that was awarded to a consortium led by the European Society of Radiology with the collaboration of the European Society of Paediatric Radiology and other European stakeholders involved in the radiation protection of children. The main aims of this project were to establish European DRLs to be used by countries without their own national paediatric DRLs and to provide a consistent method to establish new DRLs in the future. These European guidelines have been very recently endorsed by the European Commission and published in issue N degrees 185 of the Radiation Protection series. The purpose of this article is to introduce these guidelines to the wide community of paediatric radiologists. ; Peer reviewed

The European Directive 2013/59/EURATOM requires member states of the European Union to ensure justification and optimisation of the radiological procedures and to include information on patient exposure as part of the report of the examinations. The EuroSafe Imaging campaign of the European Society of Radiology created a working group (WG) on "Dosimetry for imaging in clinical practice" with the aim to help with the dosimetry aspects required by European and national regulations. The primary focus topics were selected and a survey among the experts of the WG, allowed suggesting some initial consensus approaches. For information on patient exposure, it was agreed to include the dosimetric values reported by the imaging modalities (validated by a medical physics expert). It was also suggested to prepare educational material on dosimetric quantities for patients. Individual optimisation was considered a challenge, especially for interventional procedures. In these cases, patient and occupational doses should be part of the global optimisation process and trigger levels should be defined to avoid skin radiation injuries. Diagnostic Reference Levels (DRLs) always need to be considered for comparison with periodic patient dose audits. In the case of accidental or unintended exposures, a report should be produced for the Quality Assurance programme, together with an educational note to avoid the repetition of incidents. Dose registry and management systems should allow fulfilling the regulatory requirements of national and European regulations. In a second step, and after the initial experience with the Directive implementation, a wider survey will be considered.