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THE SIZE-SPECIFIC DOSE ESTIMATE OF PAEDIATRIC HEAD CT EXAMINATIONS FOR VARIOUS PROTOCOLS
Arif Fahmi1, Choirul Anam1, Mohd Hanafi Ali2
1Department of Physics, Faculty of Sciences and Mathematics, Diponegoro University, Jl. Soedarto SH, Tembalang, Kec. Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia.
Insights
Paediatric head CT scans show lower radiation doses with specialized protocols compared to general ones. Implementing tailored paediatric head CT protocols is crucial for minimizing radiation exposure in young patients.
Area of Science:
- Medical Imaging
- Radiology
- Paediatric Health
Background:
- Computed tomography (CT) is vital for paediatric diagnostics.
- Radiation dose optimization in paediatric CT is a significant concern.
- Variations in CT protocols can lead to differing radiation doses.
Purpose of the Study:
- To evaluate size-specific dose estimates (SSDE) in paediatric patients undergoing head CT.
- To compare SSDE across different head CT protocols used in Indonesian hospitals.
- To determine the effectiveness of a dedicated paediatric head CT protocol.
Main Methods:
- Retrospective analysis of head CT examinations from 2017-2018.
- Categorization of paediatric patients into three age groups (0-1.5, 1.5-5, 5-18 years).
- Calculation of CTDIvol, effective diameter, water-equivalent diameter, and SSDE using IndoseCT software from DICOM files.
Main Results:
- The dedicated paediatric head CT protocol (11.1) resulted in significantly lower SSDE compared to axial (1.1) and helical (1.2) routine head protocols.
- Protocol 11.1 showed a 20% dose reduction, while protocols 1.1 and 1.2 showed 37% and 43% dose reductions, respectively, compared to an unspecified baseline or each other.
- SSDE varied across different age groups within the paediatric population.
Conclusions:
- The specialized paediatric head CT protocol (11.1) is more effective in reducing radiation dose for children.
- Adoption and consistent implementation of paediatric-specific CT protocols are essential.
- Education for medical personnel on paediatric CT protocols can prevent excessive radiation exposure in children.
Abstract:
The purpose of this study was to evaluate the size-specific dose estimates (SSDE) of paediatric patients who underwent head computed tomography (CT) examinations for various protocols in the Patut Patuh Patju Hospital, West Lombok, Indonesia. Three types of protocols commonly used in the paediatric head CT examinations during 2017-2018 were protocols of 1.1 (axial routine head), 1.2 (helical routine head) and 11.1 (paediatric head). Patients were divided into three age groups (0-1.5, 1.5-5 and 5-18 year). Data of computed tomography dose index volume (CTDIvol) were obtained from Digital Imaging and Communications in Medicine (DICOM) files of patient CT images. The effective diameter, water-equivalent diameter and SSDE were calculated from the patient's CT image using the IndoseCT software. This research pointed out that SSDE for the paediatric head protocol was far lower than the axial and helical routine head protocols. It was found that the implementation of the 11.1, 1.1 and 1.2 protocols were 20, 37 and 43%, respectively. It is essential for education to the medical personnel involved to implement the protocol of paediatric head CT to avoid an excessive dose of paediatrics in the head CT examination.
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