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Optimised paediatric CT dose at a tertiary children's hospital in Japan: a 4-y single-centre analysis
Y Nakada1, M Fujiwara2, M Yakami3
1National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, Japan.
Insights
Diagnostic reference levels (DRLs) for pediatric CT scans were established in Japan. Head CT scans were slightly above average, while chest and abdomen scans were below average, indicating good optimization.
Area of Science:
- Medical Imaging
- Radiology
- Pediatric Imaging
Background:
- Diagnostic Reference Levels (DRLs) are crucial for optimizing radiation dose in medical imaging.
- Currently, established DRLs for pediatric CT examinations are lacking in Japan.
- Tertiary care children's hospitals play a vital role in specialized pediatric imaging.
Purpose of the Study:
- To determine local Diagnostic Reference Levels (DRLs) for a comprehensive range of pediatric CT examinations.
- To evaluate the optimization status of CT examinations in a Japanese tertiary care children's hospital.
- To provide a benchmark for pediatric CT radiation dose in Japan.
Main Methods:
- Retrospective analysis of 4801 pediatric CT examination records (patients <15 years old) from 2008-2011.
- Data collection included CTDIvol and DLP for various examinations like head, cardiac, temporal bone, abdomen, and chest.
- Benchmarking of local DRLs against established values from five countries.
Main Results:
- The most frequent pediatric CT examinations were head (52%), cardiac (15%), and temporal bone (9%).
- Mean CTDIvol and DLP increased with age for head, chest, and abdomen CT scans.
- CTDIvol, DLP, and effective dose for chest and abdomen CT were below international averages, while head CT values were near or slightly above average.
Conclusions:
- The CT examinations performed at this tertiary children's hospital in Japan appear to be well-optimized.
- Established local DRLs provide a valuable reference for pediatric CT practice in Japan.
- Further studies are needed to establish nationwide pediatric DRLs in Japan.
Abstract:
Since diagnostic reference levels (DRLs) for children are not currently established in Japan, the authors determined local DRLs for the full range of paediatric CT examinations in a single tertiary care children's hospital. A retrospective review of 4801 CT performance records for paediatric patients (<15 y old) who had undergone CT examinations from 2008 to 2011 was conducted. The most frequent examinations were of the head (52 %), followed by cardiac (15 %), temporal bone (9 %), abdomen (7 %), chest (6 %) and others (11 %). Approximately one-third of children received two or more CT scans. The authors' investigation showed that mean CTDIvol and DLP for head, chest and abdomen increased as a function of age. Benchmarking of the results showed that CTDIvol, DLP and effective dose for chest and abdomen examinations in this hospital were below average, whereas those for the head tended to be at or slightly above average of established DRL values from five countries. The results suggest that CT examinations as performed in a tertiary children's hospital in Japan are well optimised.