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Patient characteristics associated with differences in radiation exposure from pediatric abdomen-pelvis CT scans: a
Jennifer N Cooper1, Daniel L Lodwick2, Brent Adler3
1Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Pediatric computed tomography (CT) scans show that older age, female gender, higher BMI, and multiphase or repeat scans are linked to increased radiation exposure. Targeted dose reduction efforts are recommended for these patient groups.
Area of Science:
- Pediatric radiology
- Medical imaging
- Radiation oncology
Background:
- Computed tomography (CT) is a vital diagnostic tool in pediatric medicine.
- Concerns about radiation exposure necessitate identifying factors influencing radiation burden in children.
- Understanding these factors is crucial for effective dose reduction strategies.
Purpose of the Study:
- To identify demographic and clinical characteristics associated with higher radiation exposure from single abdomen/pelvis CT scans in children.
- To analyze the impact of patient-specific factors on effective dose in pediatric CT imaging.
- To guide targeted radiation dose reduction in pediatric CT examinations.
Main Methods:
- Analysis of 2390 abdomen/pelvis CT scans performed on patients under 16 years of age.
- Utilized software to estimate patient-specific organ and effective doses.
- Employed quantile regression models to assess the influence of patient characteristics on effective dose.
Main Results:
- Older age, female gender, higher Body Mass Index (BMI), and multiphase or repeat scans were significant predictors of higher effective dose.
- These associations were consistent across different dose percentiles (50th, 75th, 90th).
- The impact of obesity and scan complexity (multiphase/repeat) on effective dose was amplified in higher-dose scans.
Conclusions:
- Older age, female gender, obesity, and multiphase or repeat scanning are associated with increased effective dose in pediatric abdomen/pelvis CT.
- These findings highlight specific groups for targeted radiation dose reduction interventions.
- Further research and protocol optimization are needed to minimize radiation burden in vulnerable pediatric populations.
Background:
Computed tomography (CT) is a widely used diagnostic tool in pediatric medicine. However, due to concerns regarding radiation exposure, it is essential to identify patient characteristics associated with higher radiation burden from CT imaging, in order to more effectively target efforts towards dose reduction. Our objective was to identify the effects of various demographic and clinical patient characteristics on radiation exposure from single abdomen/pelvis CT scans in children.
Methods:
CT scans performed at our institution between January 2013 and August 2015 in patients under 16 years of age were processed using a software tool that estimates patient-specific organ and effective doses and merges these estimates with data from the electronic health record and billing record. Quantile regression models at the 50th, 75th, and 90th percentiles were used to estimate the effects of patients' demographic and clinical characteristics on effective dose.
Results:
2390 abdomen/pelvis CT scans (median effective dose 1.52mSv) were included. Of all characteristics examined, only older age, female gender, higher BMI, and whether the scan was a multiphase exam or an exam that required repeating for movement were significant predictors of higher effective dose at each quantile examined (all p<0.05). The effects of obesity and multiphase or repeat scanning on effective dose were magnified in higher dose scans.
Conclusions:
Older age, female gender, obesity, and multiphase or repeat scanning are all associated with increased effective dose from abdomen/pelvis CT. Targeted efforts to reduce dose from abdominal CT in these groups should be undertaken.