SU-E-I-110: Minimized Pediatric Dose in Direct Radiography (DR)

Area of Science:

• Radiology
• Medical Imaging
• Pediatric Imaging

Background:

• Pediatric X-ray techniques lack standardization, often relying on default manufacturer settings.
• Variability exists based on patient size, anatomy, and equipment manufacturer.

Purpose of the Study:

• To identify optimal pediatric X-ray techniques balancing radiation dose and image quality.
• To evaluate factors influencing diagnostic image quality and patient exposure.

Main Methods:

• Assessed kVp, mA, time, grid use, collimation, focal spot size, AEC/manual settings, and filters.
• Measured entrance skin exposure, detector exposure, exposure index (EI), and contrast-to-noise ratio (CNR).
• Evaluated techniques across neonatal to average child sizes for Philips and GE equipment.

Main Results:

• Some manufacturer techniques resulted in higher entrance skin exposure than standard methods.
• Equipment exposure index (EI) is not a reliable dosimeter.
• Lower kVp/mA with longer exposure improved contrast-to-noise ratio (CNR) but increased skin dose.
• Grid/filter removal reduced dose but decreased low contrast detectability; focal spot size had minimal impact.

Conclusions:

• No universal technique optimizes both dose and image quality for all pediatric patients.
• Technique selection depends on exam type and patient size.
• Implementing optimized techniques involves complex generator programming and parameter adjustments.