[Chest computed tomography in children: indications, efficiency and effective dose].

Area of Science:

• Pediatric Pulmonology
• Radiology
• Medical Imaging

Background:

• Advancements in multidetector row computed tomography (CT) have expanded its use in diagnosing pediatric respiratory diseases.
• Computed tomography (CT) involves radiation exposure, a significant concern in pediatric patients due to their increased sensitivity and longer life expectancy.

Purpose of the Study:

• To evaluate the primary indications for chest CT in pediatric pulmonology.
• To assess the diagnostic and management contributions of chest CT in children.
• To analyze the radiation doses associated with pediatric chest CT examinations.

Main Methods:

• An observational, prospective study included 135 children undergoing chest CT from November 2009 to April 2010.
• Data collected included demographics, CT findings, diagnostic/management contributions, and radiation doses (dose-length product and effective dose).
• Radiation doses were compared across different CT scanners (128-slice dual-source, 64-slice single-source) and institutions.

Main Results:

• The main indications for chest CT were bronchial disease (44%), infectious disease (16%), and interstitial disease (14%).
• Chest CT directly contributed to diagnosis in 48% of diagnostic scans and 38% of follow-up scans, and to treatment in 24% and 19% of cases, respectively.
• Effective radiation doses were significantly lower with the 128-slice CT (0.61 mSv) compared to 64-slice CT (1.24 mSv) and scans performed outside the university hospital (2.56 mSv).

Conclusions:

• Chest CT plays a crucial role in diagnosing and managing pediatric lung diseases.
• Minimizing radiation exposure is paramount in pediatric CT due to increased radiosensitivity and long-term risks.
• Significant variations in radiation doses necessitate concerted efforts by radiologists and pediatricians to reduce exposure in children.