2021 NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR PAEDIATRIC COMPUTED TOMOGRAPHY IN EGYPT

Area of Science:

• Medical Imaging and Radiation Protection
• Paediatric Radiology
• Health Physics

Background:

• Establishing national diagnostic reference levels (NDRLs) is crucial for optimizing radiation dose in paediatric computed tomography (CT).
• Egypt lacked specific national guidelines for paediatric CT radiation doses prior to this study.
• International comparisons are essential to benchmark national practices and identify areas for improvement.

Purpose of the Study:

• To establish the first national diagnostic reference levels (NDRLs) for common paediatric CT examinations in Egypt.
• To assess current radiation dose levels in Egyptian paediatric CT practices.
• To provide a basis for radiation dose optimization and justification in paediatric CT.

Main Methods:

• A prospective study involving 1680 paediatric patients across all dedicated paediatric imaging centers in Egypt.
• Collection of computed tomography dose index (CTDIvol) and dose-length product (DLP) data for head, chest, and abdomen-pelvis CT scans.
• Analysis and comparison of Egyptian data with international paediatric DRLs from 14 countries.

Main Results:

• Egyptian NDRLs for CTDIvol (mGy) ranged from 4 to 32 across age groups and scan types.
• Egyptian NDRLs for DLP (mGycm) ranged from 67 to 637 across age groups and scan types.
• Established NDRLs were found to be similar to or lower than international DRLs, but variations between centers highlighted the need for dose optimization.

Conclusions:

• This study presents the first Egyptian national diagnostic reference levels for paediatric CT.
• While NDRLs are reasonable, variations in practice indicate challenges in radiation dose optimization and justification for children.
• The findings provide a foundation for improving radiation safety in paediatric CT across Egypt.