Multislice CT of the head and body routine scans: Are scanning protocols adjusted for paediatric patients?

To investigate whether the multislice CT scanning protocols of head, chest and abdomen are adjusted according to patient's age in paediatric patients.

Multislice CT examination records of paediatric patients undergoing head, chest and abdomen scans from three public hospitals during a one-year period were retrospectively reviewed. Patients were categorised into the following age groups: under 4 years, 5-8 years, 9-12 years and 13-16 years, while the tube current was classified into the following ranges: < 49 mA, 50-99 mA, 100-149 mA, 150-199 mA, > 200 mA and unknown.

A total of 4998 patient records, comprising a combination of head, chest and abdomen CT scans, were assessed, with head CT scans representing nearly half of the total scans. Age-based adjusted CT protocols were observed in most of the scans with higher tube current setting being used with increasing age. However, a high tube current (150-199 mA) was still used in younger patients (0-8 years) undergoing head CT scans. In one hospital, CT protocols remained constant across all age groups, indicating potential overexposure to the patients.

This analysis shows that paediatric CT scans are adjusted according to the patient's age in most of the routine CT examinations. This indicates increased awareness regarding radiation risks associated with CT. However, high tube current settings are still used in younger patient groups, thus, optimisation of paediatric CT protocols and implementation of current guidelines, such as age-and weight-based scanning, should be recommended in daily practice.