To keep the radiation dose as low as reasonably achievable (ALARA) is important in general and more important in pediatric radiology practice. [1,2]. Some researcher is trying to evaluate the effects of lowering the detector entrance exposure in children undergoing interventional radiology procedures. The others study examines the radiation dose in a pediatric population during intraoperative radiological screening [3]. Our main goal was to introduce different approaches in a pediatric hospital for diminishing children x-ray radiation including revise feasibility of x-ray studies, considering non-radiation methods,...

In 15 pediatric departments (pediatric general surgery, pediatric gastrointestinal surgery, pediatric thoracic surgery, pediatric neurosurgery, pediatric ENT, maxilla-facial surgery, neonatal surgery, trauma & orthopedic, plastic surgery, ICU, general pediatrics, neonates and infant’s department, pediatric gastroenterology, pediatric neurology, physiotherapy and rehabilitation) of the hospital with 252 beds each year there were done about 50.000 x-ray and CT- scan examinations. During the last ten years, we implemented a program [4,5] for diminishing of radiation in children practice (Fig.1) which included: 1st-refuse unnecessary x-ray examinations 2nd-substitute x-ray and...

1st- We refused x-ray examinations for thymus hyperplasia (Fig.2) used previously as the standard (more than 600 each year) and limited the number of multiple x-ray follow-up examinations (more than 700 each year). 2nd- We widely used ultrasound for emergency (about 3000 procedures each year). Ultrasound also used in the operation room during neurosurgery. Intraoperative navigated neuro ultrasound in elective and urgent infant, and pediatric neurosurgery was performed for patients from one month to twelve years old with sector & linear probes, CD & PD....

To diminish x-ray radiation in the children radiology practice it is essential to implement all the spectrum of medical devices, medical knowledge’s and organizations principles including: refuse unnecessary x-ray examinations, substitute x-ray and CT- scan by non-radiation methods and implement a new generation of x-ray and CT-scan with low doses radiation. The multimodal approach in the pediatric hospital during the last years allow us to decrease children radiation in its different departments from 10% to 60%.

Prof.AndriasM. Hambardzumyan St. Astvatsamayr Medical Center, Department of Radiology Address: Artashisian str. 46a, 0039 Yerevan, Armenia Endovision Medical Center e-mail: [email protected]

1.Wildgruber M,Köhler M,Brill R,Goessmann H,Uller W,Müller-Wille R,Wohlgemuth WA. (2018). Impact of low dose settings onradiationexposure duringpediatricfluoroscopic guided interventions.Eur J Radiol.Mar;100:1-6. DOI: 10.1016/j.ejrad.01.011.Epub 2018 Jan 9. 2. IAEA survey of pediatric computed tomography practice in 40 countries in Asia, Europe, Latin America, and Africa: procedures and protocols European Society of Radiology 2012 DOI 10.1007/s00330-012-2639-3. Acknowledgments. The work was undertaken as part of the technical cooperation projects of the International Atomic Energy Agency. European Society of Radiology (2012), European Radiology, 2639-3 3.Friend J,Lindsey-Temple S,Gollow I,Whan E,Gera P....