A study to establish international diagnostic reference levels for paediatric computed tomography.

Area of Science:

• Medical Physics
• Radiology
• Paediatric Imaging

Background:

• Paediatric computed tomography (CT) radiation doses vary significantly.
• Establishing international standards is crucial for optimizing radiation safety in children.

Purpose of the Study:

• To conduct the largest international survey of paediatric CT doses.
• To propose international diagnostic reference levels (DRLs) for paediatric CT.
• To evaluate the use of median versus mean patient dose values for DRLs.

Main Methods:

• Collected 6115 individual patient data from 32 countries across four paediatric age groups.
• Recorded CTDIw, CTDI vol, and DLP from CT consoles.
• Established DRLs using the 75th percentile of the distribution of median values from facilities.

Main Results:

• Established international DRLs for head, chest, and abdomen CT in paediatric patients.
• Median values are recommended over mean values for representing typical local doses.
• DRLs for CTDI vol align with existing reports, with variations noted for chest and abdomen CT.

Conclusions:

• The proposed international DRLs can guide countries with limited medical physics support.
• The study provides recommendations for improving future dose surveys.
• Median-based DRLs offer a more robust measure for optimizing paediatric CT radiation doses.