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Radiation dose evaluation of pediatric patients in CT brain examination: multi-center study
Fotso Kamdem Eddy1, Samba Odette Ngano2,3, Fotue Alain Jervé2
1Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon. eddyfotsokamdem@yahoo.fr.
Insights
Cameroon lacks pediatric radiation dose standards. A study found CT scans in Cameroonian hospitals significantly exceed French Diagnostic Reference Levels (DRL), necessitating protocol optimization for pediatric radiation protection.
Area of Science:
- Medical Physics
- Radiology
- Radiation Protection
Background:
- Cameroon currently lacks established Pediatric Regulatory Diagnostic Reference Levels (DRL).
- Diagnostic Reference Levels (DRLs) are crucial for optimizing radiation exposure and ensuring patient safety in medical imaging.
- France utilizes DRLs to standardize and optimize examination protocols.
Purpose of the Study:
- To evaluate radiation dose and acquisition parameters in pediatric cranial CT scans in Cameroon.
- To compare these parameters against France's DRL to identify potential optimization needs.
- To propose the development of DRLs for pediatric CT in Cameroon.
Main Methods:
- A retrospective, multicenter study involving 320 pediatric patients undergoing cranial CT scans.
- Analysis of CT acquisition parameters: tube potential (kV), tube current (mA), slice thickness (T), scanning techniques, CTDIvol, and DLP.
- Comparison of the 75th percentile dose values with France's DRL.
Main Results:
- Pediatric CTDIvol values in Cameroonian centers were higher than France's DRL across all age groups (1-4, 5-9, 10-14 years).
- Dose Length Product (DLP) values also showed a similar trend of being higher than French DRLs.
- A significant dosimetric overshoot was observed, indicating a need for protocol adjustments.
Conclusions:
- Cameroonian pediatric CT protocols result in higher radiation doses compared to established international benchmarks (France's DRL).
- Urgent need to implement DRLs and optimize protocols to ensure radiation protection for pediatric patients.
- Establishment of a quality control structure is recommended for consistent application of radiation safety principles in Cameroon.
Abstract:
There is currently no Pediatric Regulatory Diagnostic Reference Level (DRL) in Cameroon to standardize protocols in hospitals. France, a European country, has DRL allowing them to optimize their examination protocol. For the sake of radiation protection, we have proposed to evaluate the dose and acquisition parameters delivered to our pediatric patients to optimize the protocols used. We also compared the 75th percentile values of dose parameters by acquisition between the three hospitals to Diagnostic Reference Level (DRL) of France. In this retrospective and evaluative multicenter study, a total of 320 patients who had at least one cranial CT scan were enrolled from three medical centers. The CT acquisition parameters including tube potential (kV), tube current (mA), slice Thickness (T), spiral or sequential scanning techniques, volume CT dose index (CTDIvol), and dose length product (DLP) were analyzed. CTDIvol values in our centers were found up to 17.42%, 46.01%, 21.56% respectively for children aged 1-4 higher than values of France's DRL. For those aged 5-9, we obtained 44.58%, 43.15%, 42.21% respectively. In addition, for children aged 10-14 there are also up to 47.73%, 44.11%, 46.39% respectively higher than values of France's DRL. It is similary for DLP values. The study showed a significant dosimetric overshoot compared to the France's DRL and prompted us to make corrections to the protocols used and to a more rigorous monitoring of the principles of radiation protection and optimization rules in pediatric computed tomography in our hospitals. Our results have led us to make changes to our protocols which are the subject of a new dosimetric evaluation. The development of DRL for improving the pediatric CT scan in our country is necessary to optimize our protocols. Our results have led us to make changes to our protocols which are the subject of a new dosimetric evaluation. It would be necessary to set up a quality control structure in Cameroon and their applications in current practice.
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