EuroSafe Imaging 2020
Action 7 - Radiation protection of children, Paediatric, Radioprotection / Radiation dose, CT, Diagnostic procedure, Radiation safety, Quality assurance, Retrospective, Not applicable, Performed at one institution
V. Georgopoulou, M. Sidiropoulou, S. Papadopoulos, E. Papageorgiou, A. Anastasiou
Description of activity and work performed
Three radiologists retrospectively reviewed and evaluated the justification of CT exams on children based on the American College of Radiology Appropriateness Criteria ® and medical expertise. Patient data (age, symptoms, referring clinic) and diagnostic outcome (positive, ie when there were findings related to the symptoms stated/negative, ie when there were no findings or the ones found were irrelevant to the symptoms or the purpose of the ct examinaion) were recorded and statistically analyzed.
Two hundred forty three paediatric CT exams were analyzed. One hundred fourteen were head, 63 chest, 34 abdomen, 28 spinal cord and 4 extremities CT exams.
Fig. 1: The number of Paediatric CT exams
Thirty one exams (13%) were found to be unjustified and could have been replaced by MRI, US or radiographs. Fifteen of the unjustified exams were cervical/lumbar spine exams referred for suspected spine trauma, 8 head CT (referred mainly for head trauma), 5 abdominal and 3 extremities exams.
Fig. 2: The Unjustified & Justified CT exams
More unjustified exams were recorded for teenagers (p<0.001).
Fig. 3: The Unjustified CT exams vs Children's Age
Most of the unjustified exams were referred by paediatric surgeons compared to paediatricians (p<0.001)
Fig. 4: The Unjustified CT exams vs Referral Clinic
Twenty two (71%) of the unjustified exams had negative outcome. The odds of having negative outcome for the unjustified exams compared with the justified ones were fivefold (p=0.001).