Background/Introduction
It isestimated that more than 62 million CT scans are performed each year in the US.
Approximately 8-10% of CT examinations are performed in children.
The growth in CT utilization is higher in the pediatric than adult population,
particularly in teenagers undergoing chest CT in the emergency department.
Children are more sensitive to radiation relative to adults by afactor of 3-5.
Their tissues are more radiosensitive,
they have longer lifetime to manifest radiation-induced injury,
and in addition,
each exam is cumulative.
Girls are more at...
Description of activity and work performed
To keep radiation dose as low as reasonably achievable,
two guiding principles must be followed: 1- CT exams must be appropriately justified for clinical need.
2- All technical aspects of each CT examination must be optimized.
There are some factors that contribute to unnecessary CT exams,
such as overcautious ordering,
time saving (immediate result is possible),
and lack of alternative examination modality.
The first step is to make sure the exam is well justified.
We should not perform the study if not indicated,
or consider...
Conclusion and Recommendations
The main principles for dose reduction in pediatric CT are:
1.- A rigorous justification of the exam
2.- Adequate preparation of the patient
3.- Accept image noise as long as the scan is diagnostic.
Define the appropriate target image quality.
4.- Optimise scan parameters
5.- Limit scan coverage
6.- Avoid non-justified multiple scans of the same area
7.- Make use of the iterative reconstruction techniques,
if available
8.- Pay attention to radiation dose values and compare with diagnostic reference levels (DRL).
The proper protocol depends...
Personal/Organisational information
F.
Saez.
Section Head,
Paediatric Radiology.
Hospital Universitario Cruces.
Bizkaia,
Spain
R.
Gonzalez.
Radiology Department.Hospital Universitario Cruces.
Bizkaia,
Spain
J.
J.
Fondevila.Radiology Department.Hospital Universitario Cruces.
Bizkaia,
Spain
M.
Carreras.Radiology Department.Hospital Universitario Cruces.
Bizkaia,
Spain
References
- AAPM Position Statement on the Use of Bismuth Shielding for the Purpose of Dose Reduction in CT Scanning.
Feb,
2012.
http://www.aapm.org/public general/BismuthShielding.pdf.
- ACR–ASER–SCBT-MR–SPR Practice parameter for the performance of paediatric computed tomography (CT) (revised 2014).
- Eurosafe.
Checklist: managing a safe CT service.
http://www.eurosafeimaging.org/checklist-managing-a-safe-ct-service
- Image gently.
www.pedrad.org
- Dougeni E,
Faulkner K,
and Panayiotakis G.
A review of patient dose and optimisation methods in adult and paediatric CT scanning.
Europ J Radiol 2012; 81:e665-e683.
- Kost SD,
Fraser ND,
Carver DE,
et...
