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Establishing paediatric diagnostic reference levels using reference curves - A feasibility study including
Anja Almén1, Jónína Guðjónsdóttir2, Nils Heimland3
1Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden; Department of Radiation Protection, Swedish Radiation Safety Authority, Stockholm, Sweden.
Insights
Weight-based diagnostic reference level (DRL) curves offer a practical method for assessing radiation doses in pediatric imaging. This approach enables faster dose comparisons, especially when data for specific weight groups are limited.
Area of Science:
- Medical Imaging Physics
- Radiological Protection
- Pediatric Radiology
Background:
- Establishing accurate diagnostic reference levels (DRLs) is crucial for optimizing radiation doses in pediatric medical imaging.
- Traditional methods using weight groups may require extensive data collection, posing challenges for low-frequency examinations.
Purpose of the Study:
- To derive Regional Diagnostic Reference Levels (RDRLs) for pediatric conventional X-ray and CT examinations using weight-based DRL curves.
- To compare the efficacy of weight-based DRL curves against DRLs derived from traditional weight groups.
Main Methods:
- Utilized data from 1722 examinations across 29 hospitals in four countries.
- Derived DRL curves using an exponential fit with weight as the independent variable for conventional X-ray and CT examinations.
- Compared derived DRL curves with national diagnostic reference level (NDRL) curves and DRLs from weight groups.
Main Results:
- The derived weight-based DRL curves demonstrated similarities with available NDRL curves.
- The curves corresponded well with DRLs derived from weight groups when sufficient data were present.
- Weight-based DRL curves proved feasible and comparable to weight group DRLs.
Conclusions:
- Weight-based DRL curves are a viable and practical approach for pediatric radiation dose assessment.
- DRL curves offer a significant advantage in clinical settings by enabling faster dose comparisons with fewer data points.
- This method is particularly beneficial for low-frequency examinations where establishing group-specific DRLs can be time-consuming.
Purpose:
To derive Regional Diagnostic Reference Levels (RDRL) for paediatric conventional and CT examinations using weight-based DRL curves and compare the outcome with DRL derived using the weight groups.
Methods:
Data from 1722 examinations performed at 29 hospitals in four countries were included. DRL was derived for four conventional x-ray (chest, abdomen, pelvis, hips/joints) and two types of CT examinations (thorax, abdomen). DRL curves were derived using an exponential fit to the data using weight as an independent variable and the respective radiation dose indices (PKA, CTDIvol, DLP) as dependent variables. DRL was also derived for weight groups for comparison. The result was compared with national diagnostic reference level (NDRL) curves.
Results:
The derived curves show similarities with the NDRL curves available and corresponded sufficiently well with DRL for weight groups using the same data set, if sufficient number of data was available.
Conclusions:
We conclude that weight-based DRL curves are a feasible approach and could be used together with DRL for weight groups. The main advantage of DRL curves is its application in the clinic. When the examination frequency is low, time to collect enough data to establish typical values for one or several weight groups may be unreasonably long. The curve provides the means to compare dose level faster and with fewer data points.
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