Aims and objectives
Despite the emergence of imaging modalities such as ultrasound,
magnetic resonance imaging and nuclear medicine,
projection radiography remains an essential element of investigation into paediatric pathology [1].
Paediatric patients are smaller,
less compliant and more radiosensitive than adults and so technique must be adapted to reflect these considerations [2].
When considering paediatric projection radiography,
it is of upmost importance to consider optimisation of radiation dose [3].
DRLs are an established method of dose optimisation in paediatric radiography [4].
The purpose of DRLs is to provide...
Methods and materials
Population and Sample:
In small countries with less than 50 facilities literature recommends inclusion of at least 30-50% of these facilites for the purpose of DRL establishment [5].
A stratifeid,
random sample of 12 clinical sites was generated for the current study,
representing 54% of the Irish hospitals that carry a moderate to high paediatric caseload.
This sample included two large dedicated paediatric centres,
sevenlarge general hospitals and three small general hospitals to reflect the nature of the Irish national paediatric imaging service.
Dose Quantities...
Results
Summary Data
Across the twelve hospitals,
6,633 DAP values were harvested from the NIMIS database and transcribed into SPSS. Analysis included:
Identification of median value for each projection and age group across the 12 clinical sites
Identification of 75th centile of ranked median values.
Range from highest to lowest median value
Interquartile range
Ratio maximum to minimum
Ratio third to first quartile
Dap Dose Distributions
Ranked histograms with the 75th centile indicated were constructed for each projection by age group to visually feedback the results...
Conclusion
The current study has collected and analysed DAP data from 12 Irish hospitals which x-ray children.
Undoubtedly,
considerable DAP dose variations exist between hospitals.
This highlights the value of DRLs in revealing comparisons that if scrutinised,
could lead to greater otimisation across sites which return higher doses during this tye of audit.
The definitive conclusions of the current study are:
NIMIS,
a centralised database,
can be used to generate age specific national DRL data for paediatric examinations which are performed with sufficient frequency.
75th centile...
Personal information
Cian J O'Flynn,
Radiography and Diagnostic Imaging,
University College Dublin,
Ireland
Grace O'Neill,
Radiography and Diagnostic Imaging,
University College Dublin,
Ireland
Kate Matthews,
Radiography and Diagnostic Imaging,
University College Dublin,
Ireland
References
Matthews,
K.,
Brennan,
P.
and McEntee,
M.
(2013).
‘An evaluation of paediatric projection radiography in Ireland’.Radiography,
20(3): 189-194
Billinger,
J.
Nowotny,
R.
and Homolka,
P.
(2010) ‘Diagnostic reference levels in pediatric radiology in Austria’.
European Radiology,
20(7): pp.
1572-1579.
ICRP (International Commission on Radiological Protection),
Clement,
C.H.
and Sasaki,
M.
(eds.) (2013) ‘Radiological Protection in Paediatric Diagnostic and Interventional Radiology’,
ICRP Publication 121.
Ann.
ICRP, 42 (2),
pp.1-63.
ESR (European Society of Radiology) (2016) European Guidelines on DRLs for Paediatric Imaging.
Available at: http://www.eurosafeimaging.org/wp/wp-content/uploads/2014/02/European-Guidelines-on-DRLs-for-Paediatric-Imaging_Revised_18-July-2016_clean.pdf (Downloaded...