Multi-parametric Diagnostic Reference Levels (DRL) for Pediatric CT: Data from 713 patients

Congress:

EuroSafe 2023

Poster Number:

ESI-15536

Type:

EuroSafe Imaging

Keywords:

Radioprotection / Radiation dose, CT, Radiation safety, Education and training

Authors:

M. Bernardo, L. KAROUT, F. Morgado, F. D. M. KIIPPER, A. A. Moscatelli, R. A. Lucena, M. C. C. RODEL, M. Kalra

DOI:

DOI-Link:

https://dx.doi.org/

Purpose or learning objective

Purpose or Learning Objective To investigate Pediatric DRL according to age groups and clinical indications for head, chest and abdominal CT in 4 hospitals in Brazil. We also assess how radiation dose monitoring and benchmarking can help with dose optimization.

Methods or background

Background Every medical procedure has pros and cons. The pros come from the benefit of obtaining relevant information to answer legitimate clinical queries; the cons pertain to the risk and cost of the procedure, particularly when the intended benefits cannot outweigh the anticipated benefits. For CT, harm from radiation exposure can outweigh its benefits when appropriateness or justification is ignored and when CT acquisition parameters are not optimized for patients’ age, size, body region and clinical indications. Risks from radiation are higher in children than...

Results or findings

Results Patient demographics The study included 713 children with a mean age of 8 ± 6 years. There were 342 females (342/713, 49%) and 371 males (371/713, 51%). Table 1 summaries patients’ demographics.[Table 1] Anatomic region-specific DRLs Table 2 presents DRL and AD for different body regions versus the corresponding values from European publications. The DRL and AD for most body regions and clinical indications were lower than the corresponding values from the Europe levels for your patients. For routine head CT, the 75th percentile...

Conclusion

Conclusion In conclusion, our multicenter study highlights the disparity in radiation protection in Brazil. Compared to the European DRLs, multiple factors contributed to higher doses in older patients. There is need for CT dose optimization for older/larger children (patients >10 years/weight >30 kg). In smaller children, Brazilian DRLs compare favorably with the European DRLs for corresponding CTs.

References

References 1 Protection ICoR (2013) Radiological protection in paediatric diagnostic and interventional radiology. Elsevier 2 Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. The Lancet 380:499-505 3 Ng CK (2022) Artificial intelligence for radiation dose optimization in pediatric radiology: A systematic review. Children 9:1044 4 Vañó E, Miller D, Martin C et al (2017) ICRP publication 135: diagnostic reference levels in medical imaging. Annals of...

Personal information and conflict of interest

M. O. B. Bernardo: Nothing to disclose L. KAROUT: Nothing to disclose F. Morgado: Nothing to disclose F. D. M. KIIPPER: Nothing to disclose A. A. Moscatelli: Nothing to disclose R. A. Lucena: Nothing to disclose M. C. C. RODEL: Nothing to disclose M. K. Kalra: Nothing to disclose

Fig 1: Figure 1. Flow diagram summarizing the study dates and components of CT data...

Fig 2: Figure 2: The Figures 2 to 4 shows Bar diagram summarizes 75th percentile DLP...

Fig 3: Figure 3: The Figures 2 to 4 shows Bar diagram summarizes 75th percentile DLP...

Fig 4: Figure 4: The Figures 2 to 4 shows Bar diagram summarizes 75th percentile DLP...

Table 1: Table 1. Tabular summary of CT patients’ demographics

Table 2: Table 2. AD and DRL for CTDIvol and DLP benchmarked against the European levels.