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Published on: September 11, 2011
Paediatric CT examinations in 19 developing countries: frequency and radiation dose
W E Muhogora1, N A Ahmed, J S Alsuwaidi
1Tanzania Atomic Energy Commission, PO Box 743, Arusha, Tanzania.
Insights
Paediatric computed tomography (CT) use varies significantly across developing regions. Many facilities need better radiation dose awareness and optimization for children, highlighting a need for training and monitoring.
Area of Science:
- Medical Imaging
- Radiology
- Public Health
Background:
- Computed tomography (CT) is a vital diagnostic tool, but its use in paediatric populations requires careful consideration of radiation exposure.
- Data on paediatric CT frequency and radiation doses in developing countries are scarce, hindering effective dose optimization strategies.
Purpose of the Study:
- To investigate the frequency of paediatric CT examinations in developing countries across Africa, Asia, and Eastern Europe.
- To assess the magnitude of radiation doses delivered during paediatric CT examinations in these regions.
- To identify areas for improvement in radiation protection practices for children undergoing CT scans.
Main Methods:
- A survey of 128 CT facilities in 28 developing countries was conducted to determine paediatric CT examination frequency.
- Radiation dose data, including weighted CT dose index (CTDI(w)) and dose length product (DLP), were collected from 101 facilities in 19 countries.
- Standard methods were used to assess doses for common paediatric CT examinations (chest, abdomen, pelvis).
Main Results:
- Paediatric CT examinations constituted 20%, 16%, and 5% of all CTs in participating African, Asian, and Eastern European centers, respectively.
- Eleven facilities (6 countries) used adult CT parameters for paediatric patients, indicating a lack of awareness and need for optimization.
- Significant variations in CTDI(w) (up to factor 55) and DLP (up to factor 20) were observed across regions, with generally lower doses in Japan.
Conclusions:
- There is a significant need to justify and optimize CT examinations for children in many developing countries.
- Improved awareness, targeted training programs, and consistent monitoring of radiation doses are crucial for enhancing paediatric radiation protection.
- Ensuring adequate diagnostic image quality while minimizing radiation exposure remains a key challenge.
Abstract:
The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.
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