Aims and objectives
In the past years there has been a significant increase in the number of Computed Tomography (CT) examinations in paediatric population.
Miglioretti et al.
[1] reported that CT use doubled in children less than 5 years and tripled in children aged 5-14 years the period 1996-2005.
Often,
CT examinations deliver high radiation doses contributing up to 60% of the total collective dose from all paediatric X-ray examinations [2].
Considering the potential risks associated with ionizing radiation,
especially in children,
who are more sensitive to radiation...
Methods and materials
Patient cohort: The study enrolled 851 pediatric patients who underwent head,
neck,
internal auditory canal (IAC),
chest,
and abdomen-pelvis (AP) CT examinations over an 11-month period at a dedicated children’s hospital.
Patients’ characteristics are summarized on Table 1.
CT data acquisition: All CT examinations were performed on a 16-multidetector CT with the use of age-based protocols and automatic exposure control.
Patients were scanned using iterative reconstruction algorithm (blend of 60% adaptive statistical iterative reconstruction and 40% filtered back projection).
Head CT scans were performed in...
Results
In the cohort participated 507 male (60%) and 344 (40%) female pediatric patients.
57% (481/851) of examinations were of head,
25% (213/851) of chest,
7% (62/851) of AP,
6% (51/851) of IAC and 5% (44/851) of neck.
Two-phase CT scans were performed in approximately 22% of children.
Overall,
across all age groups,
DRLs ranges for CTDIvol were (23-68),
(9-21),
(37-44),
(2-4),
(2-3) mGy; for DLP per acquisition (370-705),
(150-427),
(235-273),
(40-132),
(70-132) mGy*cm and for total DLP (451-825),
(259-536),
(273-398),
51-150),
(146-238) mGy*cm for head,...
Conclusion
The study presents pediatric local DRLs for head,
neck,
IAC,
chest and AP CT examinations according to age groups.
Although the comparison of DRLs is a challenging task due to the lack of standardization of CT protocols,
the proposed DRLs were generally lower than the European DRLs [2] for head,
chest and AP examinations.
Paediatric DRLs for neck and IAC examinations are not available in the literature mainly due to their frequency.
However,
further investigations across the country are required in order to establish national...
References
1.
Miglioretti DL,
Johnson E,
Williams A,
et al.
The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk.JAMA Pediatr.
2013;167(8):700-7.
2.
European Commission.
European Guidelines on Diagnostic Reference Levels for Paediatric Imaging.Radiation Protection No 185; 2018.
3.
European Council Directive 2013/59/Euratom on basic safety standards for protection against the dangers arising from exposure to ionising radiation and repealing Directives 89/618/Euratom,
90/641/Euratom,
96/29/Euratom,
97/43/Euratom and 2003/122/Euratom.
OJ of the EU.
L13; 57: 1–73 (2014).