Children’s sensitivity to ionising radiation makes optimising paediatric doses an important concern in medical imaging. Diagnostic reference levels (DRLs) are promoted by international guidelines [1–4] and widely used to optimise patient exposures. But establishing and updating paediatric DRLs is a challenge for most countries. In France, arrangements in place until 2019 to collect data for updating DRLs  had remained ineffective in paediatric imaging.
A survey was therefore conducted, between May and December 2016, in order to collect paediatric data for establishing new paediatric DRLs...
Description of activity and work performed
Methods and materials
A list of the most common paediatric procedures in CT, plain radiography and diagnostic fluoroscopy, associated to clinical indications and age/weight bands, was established by the SFIPP and SFR radiation protection boards.
Radiology departments of dedicated paediatric hospitals but also of general healthcare facilities were invited to collect prospective or retrospective data on procedures performed in 2015 or 2016 (Table 1), including:
Equipment data: manufacturer, model, commissioning year and technical features,
Examination data: patient age and weight, technical parameters and DRL quantities:...
Conclusion and recommendations
This study confirmed that the applicable paediatric DRLs for radiography and CT in France had become obsolete. The proposed values have been used by the French authorities in 2019 to establish the new national DRLs .
In diagnostic fluoroscopy, the new DRLs, officially established for the first time in France, will be useful to reduce the heterogeneity between departments revealed by this survey. Obviously, for such procedures where variability between patients is higher, DRLs must be properly used, not as limits or applied to a...
D. Célier is part of the French Institute for Radiological Protection and Nuclear Safety (IRSN).
H. Ducou le Pointe (Hôpital d'Enfants Armand-Trousseau), J.-F. Chateil (CHU de Bordeaux), D. Sirinelli (CHU de Tours), B. Morel (CHU de Tours) and H. Brisse (Institut Curie) are members of the French-speaking Society for Paediatric and Prenatal Imaging (SFIPP) and of the French Society of Radiology (SFR).
Institut de Radioprotection et de Sûreté Nucléaire (IRSN): 31 avenue de la Division Leclerc - 92260 Fontenay-aux-Roses - France
Société Francophone d'Imagerie Pédiatrique...
International Commission on Radiological Protection (2017) Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann ICRP 46:1–144. http://journals.sagepub.com/doi/pdf/10.1177/ANIB_46_1
International Atomic Energy Agency (2018) Radiation Protection and Safety in Medical Uses of Ionizing Radiation. IAEA Safety Standards Series No. SSG-46. https://www-pub.iaea.org/MTCD/Publications/PDF/PUB1775_web.pdf
European Commission (1999) Guidance on Diagnostic Reference Levels (DRLs) for Medical Exposures. Radiation Protection 109. https://ec.europa.eu/energy/sites/ener/files/documents/109_en.pdf
European Commission (2018) European Guidelines on Diagnostic Reference Levels for Paediatric Imaging. Radiation Protection 185. https://ec.europa.eu/energy/sites/ener/files/rp_185.pdf
Journal officiel de la République Française (2012) Arrêté du 24 octobre 2011...