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PEDIATRIC HEAD CT EXPOSURE DOSES IN TUNISIA: A PILOT STUDY TOWARDS THE ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE
Abir Bouaoun1, Latifa Ben Omrane2, Mohamed Mogaadi3
1University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis (ISTMT), LR13ES07 Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia.
Insights
Pediatric head CT scans show wide radiation dose variations across Tunisian hospitals, highlighting the need for standardized protocols and staff training to minimize patient risk and establish national diagnostic reference levels.
Area of Science:
- Medical Imaging Physics
- Radiological Protection
- Pediatric Radiology
Background:
- Radiation dose optimization in pediatric CT is crucial for minimizing long-term health risks.
- Variability in CT protocols and equipment can lead to inconsistent patient radiation exposure.
- Establishing national diagnostic reference levels (DRLs) is essential for quality assurance in pediatric imaging.
Purpose of the Study:
- To assess and analyze radiation doses in pediatric head CT examinations across different CT units in Tunisian hospitals.
- To identify variations in CT protocols and exposure settings among various healthcare facilities.
- To provide data for optimizing radiation doses and deriving national DRLs for pediatric CT.
Main Methods:
- Patient data and exposure parameters were collected for four pediatric age groups.
- Clinical protocols and exposure settings were analyzed for CTDIvol and DLP values.
- Effective and organ doses were estimated using Monte Carlo simulation software (Impact CTDosimetry).
Main Results:
- Significant variations in CT protocols and radiation doses were observed between different radiology departments and CT units.
- CTDIvol values ranged from 24.9 to 47.8 mGy, and DLP values ranged from 346 to 897 mGy cm across age groups.
- Estimated effective doses varied from 1.4 to 5 mSv, comparable to international literature values.
Conclusions:
- There is a clear need for continuous staff training in radiation protection, particularly in regional hospitals.
- The study underscores the importance of developing and updating practice guidelines through interdisciplinary collaboration.
- The findings pave the way for establishing national diagnostic reference levels (DRLs) in Tunisia for pediatric head CT.
Abstract:
The purpose of this study was to assess and analyze the radiation doses during head pediatric CT from different CT units within six Tunisian hospitals representing different geographic regions in order to optimize the dose given and minimize the radiology risk to this category of patients and towards the derivation of national diagnostic reference levels. Patient data and exposure parameters were collected for four age groups (<1, 1-5, 5-10 and 10-15 y). Clinical protocols and exposure settings were analyzed. Doses were collected in terms of CTDIvol and DLP values. Effective and Organ doses to specific radiosensitive organs were estimated using the Monte Carlo simulation software 'Impact CTDosimetry'. Results showed large variations in CT protocols and doses between different radiology departments. CTDIvol and DLP values demonstrated a broad range between the CT units and between the axial and helical scan techniques in the same unit. CTDI vol values were estimated to be 24.9, 31.7, 45.5 and 47.8 mGy for <1, 1-5, 5-10 and 10-15 y age groups, respectively. In term of DLP, median values were ~346, 528, 824, 897 mGy cm for the same age groups, respectively. Effective dose ranged from 1.4 to 5 mSv. Dose values were comparable with those reported in the literature. The study shows an evident need for continuous training of staff in radiation protection concepts, especially within the regional hospitals, emphasizes the importance of the production and the update of recommendations and good practice guidelines using interdisciplinary working groups and opens the way for the establishment of national DRLs.
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