Aims and objectives
Dose optimization has a significant role in paediatric X-ray examination,
but only a few European countries have national diagnostic reference levels (DRLs) where they have based them on their own patient dose surveys.
[1]
Children are more sensitive to ionizing radiation and they have higher life expectancy therefore it is essential to minimize stochastic effects.
[3] International Commission on Radiological Protection (ICRP) have advised DRLs as an optimization tool to distinguish examinations with unreasonably high patient dose values,
taking into account ALARA (As Low As...
Methods and materials
From 2010 to 2016,
radiation doses,
obtained in children X-ray examinations were prospectively collected using dose-area product (DAP) meter installed on the X-ray set (µGy*m2) at CCUH.
To define DRLs,
data were classified by radiographic examination (chest AP/PA projection,
head AP/PA projection,
plain abdominal X-ray),
patients body area,
and specific age group: 0,
1-2,
3-5,
6-8,
9-11,
12-14,
15-17 year old (including) children.
The dose values were converted to mGy*cm2,the 75th percentile dose was chosen as an actual value and compared to the latest paediatric...
Results
Table 1 shows the amount of paediatric X-ray examinations by year and age group.
According to results,
actual paediatric radiation doses in Latvia have continuously decreased since 2010,
from 2012 to 2013 reaching their minimum being under suggested European countries DRLs,
except for routine chest X-ray exams of 0 year old patients,
where the lowest dose levels have been observed in Germany.
Actual 75th percentile DRLs of CCUH in comparison with national DRLs of European countries are demonstrated inFigure 1-3 and Table 2-4
The eventual...
Conclusion
Comparing to the dosimetric data from 2010,
the 75th percentile dose for thorax,
abdominal and head,
skull routine X-ray examinations have decreased in all age groups and are lower than European countries DRLs,
except 0 year old chest X-ray exams.
Dose reduction practice of CCUH from 2010 - 2016 can serve as a good standard for definition of national DRLs in Latvia,
although for certain X-ray examinations radiation dose optimisation can be improved,
still following ALARA principle.
Results encourage to continue periodical update of the...
References
1 PiDRL Guidelines,Final complete draft,
8 March 2016.
Retrieved from
http://www.eurosafeimaging.org/wp/wp-content/uploads/2014/02/European-Guidelines-on-DRLs-for-Paediatric-Imaging_Revised_18-July-2016_clean.pdf
2 Roch,
P.,
Célier,
D.,
Dessaud,
C.,
& Etard,
C.
(2018).
Using diagnostic reference levels to evaluate the improvement of patient dose optimisation and the influence of recent technologies in radiography and computed tomography.European Journal of Radiology,98.
https://doi.org/10.1016/j.ejrad.2017.11.002
3 UNSCEAR.
(2006).UNSCEAR 2006 Report volume I.
Effects of ionizing radiation(Vol.
I).Retrieved from http://www.unscear.org/docs/publications/2006/UNSCEAR_2006_Report_Vol.I.pdf