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Don't forget the dose: Improving computed tomography dosing for pediatric appendicitis

K Tinsley Anderson1, Susan Greenfield1, Luke R Putnam1

  • 1Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery at McGovern Medical School at The University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, TX.

Journal of Pediatric Surgery
|October 4, 2016
PubMed

Insights

Pediatric CT radiation doses for appendicitis evaluation were significantly higher and more variable in nonmember hospitals compared to member hospitals. This highlights the need for dose reduction strategies in pediatric CT imaging.

Area of Science:

  • Radiology
  • Pediatric Imaging
  • Radiation Dose Management

Background:

  • A hospital system implemented a pediatric computed tomography (CT) radiation dose reduction program in 2010.
  • A hypothesis was formed that CT radiation doses for pediatric appendicitis evaluation would be higher in nonmember hospitals (NMH) than member hospitals (MH).

Purpose of the Study:

  • To compare pediatric CT radiation doses for appendicitis evaluation between member and nonmember hospitals.
  • To assess the variability in radiation dose across different hospital types.

Main Methods:

  • A review of preoperative CT scans for pediatric appendectomy patients (under 18 years) was conducted between April 2012 and April 2015.
  • Size Specific Dose Estimate (SSDE) and Effective Dose (ED) were calculated for each scan, incorporating patient diameter.

Main Results:

  • Of 1736 patients, 1128 underwent preoperative CT; data from 936 (MH) and 102 (NMH) were analyzed.
  • SSDE and ED were significantly higher with greater variance at NMH across all age groups (p<0.05).
  • NMH exhibited SSDE and ED values exceeding established reference levels.

Conclusions:

  • Radiation exposure from CT scans for pediatric appendicitis is significantly higher and more variable in NMH.
  • Proactive strategies to reduce both the dose and frequency of CT scans in pediatric patients are crucial.
Abstract

Keywords:
ALARAAppendicitisCtPediatrics

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