Aims and objectives
There are two dedicated paediatric hospitals in the Republic of Ireland,
Our Lady’s Children’s Hospital Crumlin (OLCHC) and Temple Street Children’s University Hospital (TSCUH).
In January 2019,
TSCUH and OLCHC merged to become part of a new hospital group,
Children’s Health Ireland (CHI).
CHI is committed to ensuring that paediatric healthcare services in Ireland continue to develop in line with international best practice standards.
Part of this standard of care is to ensure patients undergoing X-ray examinations receive radiation doses as low as reasonably achievable...
Methods and materials
Exposure factors and equipment technical parameters for all DR examinations,
across both sites,
closely followed the respective values that were recommended in the paper published by Knight et al [3] in conjunction with vendor recommendations.
Both sites carried out dose audits for a range of DR exams,
which included chest,
abdomen,
pelvis and skull procedures.
The age groups for each procedure were separated as followed,
0 – 4 weeks,
4 weeks – 1 year,
1 – 4 years,
4 – 10 years and 10 –...
Results
Table 1 (a) and (b) display the DRLs for Chest & Pelvis X-ray exams respectively,
for a range of different age groups.
Both show that there is relatively good agreement,
particularly at the older age groups 4 - < 10 years and 10 - < 15 years,
between the respective values across both paediatric sites.
The table also shows that the DAP values across both sites are significantly lower than the respective European DAP values outlined in RP 185.
Figures 1 and 2 visually illustrate...
Conclusion
Preliminary results suggest there is good agreement between the respective local DRLs across both paediatric hospitals.
Further follow-up audits are required at TSCUH for the different X-ray procedures in order to provide a more comprehensive cross site comparison of dose optimisation.
Once clinical and medical physics staff are satisfied that adequate dose optimisation has been achieved,
the exposure factors will be applied across all future paediatric sites.
This will ensure a high standard of care and dose optimisation for paediatric patients in Ireland.
Personal information
This work was a collaboration betweenTemple Street Children's University Hospital and Our Lady's Children’s Hospital Crumlin,both part of the Children’s Health Ireland Hospital Group.
References
SI No.
478 of 2002.
European Communities (Medical Ionising Radiation Protection) Regulations 2002.
RP 185,
European Guidelines on Diagnostic Reference Levels for Paediatric Imaging,
European Commission 2018
Journal of Medical Radiation Sciences,
A Paediatric X-ray Exposure Chart,
Knight et al,
2014