Purpose
Currently, children have been shown to have a higher relative risk of leukaemia, brain, skin, thyroid, and breast cancer following exposure to ionizing radiation. Thus, there is a greater concern about the harmful effects of diagnostic tests and therapeutic procedures performed with ionizing radiation, such as radiographic examinations (1). Conventional digital radiography is the most frequent diagnostic modality, and chest radiography is the most requested radiological examination in children (2). Although chestradiography is an examination with a relatively low exposure dose (Effective Dose = 0.02...
Methods and materials
Study Design
An experimental study was conducted at the Imaging Department of a public, university and general hospital (not exclusively pediatric). It was developed in 3 main steps (Figure 1):
0.Current Practice (assessment)
1. Optimization Tests
2. Quality Evaluation
3. Clinical Application.
This research got the appropriate authorizations from the Ethical Board of the hosting hospital. There was no conflict of interest in this study.
Radiological Equipment and Quality Assurance
The equipment used to perform the tests was Philips Digital Diagnost, which has a Pixium...
Results
1. Optimisation Tests
32 optimization tests were performed: 22 on the CIRS ATOM® 705 phantom and 10 on the KYOTO KAGAKU® PBU-60 phantom. For the CIRS ATOM® 705 phantom, the exposure field was 19 x 22 cm, while for the KYOTO KAGAKU® PBU-60 phantom the field was 34 x 38 cm. Focus-Detector Distance was on all 180 cm exposures.
The exposure parameters tested as well as the obtained KAP values are shown in Figures 8 (CIRS ATOM® 705 phantom)and 9 (KYOTO KAGAKU® PBU-60 phantom).
2....
Conclusion
The accomplishment of this work allowed the implementation of an optimization cycle in an ImagingDepartment for the most frequent radiographic examination at pediatric age. Experimental tests performed with phantoms showed that it would be possible to reduce exposure without compromising the quality of the exams. The clinical implementation of the protocol hassubstantially reduced radiation exposure at all weight classes: 60% atclass 2, 75% atclass 3, 59% at class 4 and 54% at class 5.
Personal information and conflict of interest
C. I. D. C. T. Martins; Lisbon/PT - nothing to disclose F. M. Nogueira; Casal da Barota - Belas/Massamá Norte, LISBOA/PT - nothing to disclose J. Santos; Coimbra/PT - nothing to disclose
References
1. Kutanzi KR, Lumen A, Koturbash I, Miousse IR. Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations. Int J Environ Res Public Health. 2016;13(1057):1–14.
2. Don S, Macdougall R, Strauss K, Moore QT, Goske MJ, Herrmann T, et al. Image Gently Campaign Back to Basics Initiative: Ten Steps to Help Manage Radiation Dose in Pediatric Digital Radiography. Am J Roentgenol. 2013;200(May):W431–6.
3. Organização Mundial de Saúde, Escola Superior de Tecnologia da Saúde do Instituto Politécnico de Coimbra. Comunicar os Riscos da Radiação em Imagiologia Pediátrica [Internet]....