Congress:
EuroSafe Imaging 2019
Keywords:
Action 7 - Radiation protection of children, Action 2 - Clinical diagnostic reference levels (DRLs), Paediatric, CT, Physics, Dosimetry, Dosimetric comparison
Authors:
D. Yanikian Nersissian, H. Leao Filho, C. S. Melo, V. Heidorne Guerra, R. Gonçalves Freitas, M. V. Y. Sawamura, E. M. M. S. GEBRIM, P. R. Costa
DOI:
10.26044/esi2019/ESI-0038
Description of activity and work performed
This work was focused on protocol optimization Head and Thorax exams,
primarily.
The first strategy was comparing the configuration of these protocols with the suggested by American Association of Physicist in Medicine (AAPM) in the Alliance for Quality Computed Tomography for routine pediatric Chest CT and Head CT.
Initially,
one CT equipment (Philips – Brilliance 64) of the facility was prioritized. Figure 1 shows a flow chart relating the steps conducted for the optimization process of paediatric chest and head CT by the Brazilian participant.
Figure 1 – Flow chart relating the steps conducted for the optimization process of paediatric chest and head CT by the Brazilian participant
The responsible radiologist and the radiographer checked the proposal and suggested some changes.
The first comment of the radiographers was that protocols were with high dose and they liked to try some lower mAs values then the suggested by AAPM.
The medical physicist and the responsible radiographer have adapted the protocols for some ages for Head CT (0 - 1 year,
1 - 2 years,
2 - 6 years,
6 - 16 years and 16 - 20 years) in axial mode e one protocol for helical mode,
when 3D reconstructions were necessary.
For Chest CT,
was suggested just three divisions (0 - 1 year,
1 - 10 years and 10 - 15 years) all in helical mode.
The radiographers were trained in the news protocols which were let together in the same CT console screen with the adult’s protocols and started to use them in the exams.
After some weeks,
the medical physicist group checked some of the Head and Chest protocols and figure out the radiographers were using the helical 3D routine Head for all the pediatric patients.
The Chest protocols were well used,
because there weren´t so many options to choose.
At this time of the implementation of the new protocols none radiologist asked to change some parameters,
complaining about the noise or other loss of image quality.
Another intervention was done,
separating the pediatric from adult protocols and the medical physicist has followed some pediatric exams for training the whole team of radiographers,
asking for technical question or others suggestions.
In order to simplify the choice of the adequate protocols by the radiographers,
the monitor screen of the CT equipment console was adapted considering the specificities of the paediatric patients and a color code (Figure 2).
Figure 2 - Adapted screens of the CT equipment considering the specific paediatric protocols