Paediatric diagnostic reference levels for common radiological examinations using the European guidelines.

Area of Science:

• Radiological Protection
• Medical Imaging
• Paediatric Healthcare

Background:

• Diagnostic Reference Levels (DRLs) are crucial for optimizing radiation dose in medical imaging.
• Establishing paediatric-specific DRLs is essential due to anatomical and physiological differences in children.
• European guidelines provide a framework for deriving DRLs, but their application in paediatric populations requires investigation.

Purpose of the Study:

• To assess the feasibility of deriving regional DRLs for paediatric conventional and CT examinations.
• To compare DRLs derived using weight-based versus age-based patient groups.
• To evaluate the applicability of European guidelines for paediatric DRL determination.

Main Methods:

• Multi-centre data collection from 31 hospitals across 4 countries.
• Inclusion of 7 examination types and 2978 paediatric patients.
• Derivation of DRLs for weight and age groups, with a minimum of 15 patients per group.

Main Results:

• Feasible derivation of RDRLs for most, but not all, paediatric groups.
• Substantial differences observed between weight-based and age-based DRLs.
• Derived RDRLs were generally lower than or equal to existing European and national DRLs.

Conclusions:

• Deriving paediatric DRLs is feasible, but requires careful review of clinical indications and methodologies prior to data collection.
• Weight-based DRLs are recommended for paediatric populations, emphasizing the need for actual patient weight data.
• Age-based and weight-based DRLs are not interchangeable, highlighting the need for harmonized methods in paediatric radiology.