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Helical CT of the body: are settings adjusted for pediatric patients?
A Paterson1, D P Frush, L F Donnelly
1Department of Radiology, Royal Belfast Hospital for Sick Children, 180 Falls Rd., Belfast BT12 6BE, Northern Ireland.
Insights
Pediatric helical CT scanning parameters, including tube current, collimation, and pitch, are not adjusted for patient age. This suggests children may receive unnecessarily high radiation doses during CT scans.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Imaging
Background:
- Helical computed tomography (CT) is a common imaging modality in pediatric patients.
- Radiation dose optimization is crucial in pediatric imaging due to increased radiosensitivity.
- Current scanning protocols may not adequately account for age-related differences in pediatric patients.
Purpose of the Study:
- To investigate whether helical CT scanning parameters are adjusted based on patient age in pediatric populations.
- To assess if age-specific adjustments are made to radiation dose determinants like tube current, kilovoltage, collimation, and pitch.
Main Methods:
- A prospective study included 58 helical CT examinations of neonates, infants, and children (0-16 years).
- Examinations were categorized into age groups: 0-4, 5-8, 9-12, and 13-16 years.
- Key scanning parameters including tube current, kilovoltage, collimation, and pitch were recorded and analyzed.
Main Results:
- No evident adjustment in tube current was observed based on patient age.
- Mean tube current settings for chest (213 mA) and abdomen (206 mA) showed no age-related modification.
- A significant proportion of examinations for younger children (≤8 years) used wider collimation (>5 mm) and a pitch of 1.0.
Conclusions:
- Helical CT scanning parameters in pediatric patients are not consistently adjusted for age or examination type.
- The findings indicate a potential for unnecessarily high radiation exposure in pediatric patients undergoing body CT.
- Standardization of age-adjusted protocols is recommended to optimize radiation dose in pediatric helical CT.
Objective:
Our objective was to determine whether adjustments related to patient age are made in the scanning parameters that are determinants of radiation dose for helical CT of pediatric patients.
Subjects And Methods:
This prospective investigation included all body (chest and abdomen) helical CT examinations (n = 58) of neonates, infants, and children (n = 32) referred from outside institutions for whom radiologic consultation was requested. Information recorded included tube current, kilovoltage, collimation, and pitch. Examinations were arbitrarily grouped on the basis of the individual's age: group A, 0-4 years; group B, 5-8 years; group C, 9-12 years; and group D, 13-16 years old.
Results:
Thirty-one percent (18/58) of the CT examinations were of the chest and 69% (40/58) were of the abdomen. Sixteen percent (9/58) of the CT examinations were combined chest and abdomen. In 22% (2/9) of these combined examinations, tube current was adjusted between the chest and abdomen CT; in one (11%) of these examinations, the tube current was higher for the chest than for the abdomen portion of the CT examination. The mean tube current setting for chest was 213 mA and was 206 mA for the abdomen, with no evident adjustment in tube current based on the age of the patient. Fifty-six percent of the examinations of neonates, infants, or children 8 years old or younger were performed at a collimation of greater than 5 mm and 53% of these examinations were performed using a pitch of 1.0.
Conclusion:
Pediatric helical CT parameters are not adjusted on the basis of the examination type or the age of the child. In particular, these results suggest that pediatric patients may be exposed to an unnecessarily high radiation dose during body CT.
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