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Related Experiment Video

Updated: Jul 27, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Establishing weight-based diagnostic reference levels for neonatal chest X-rays.

R Gilley1, L R David2, B Leamy3

  • 1Medical Imaging and Radiation Therapy, University College Cork, Ireland.

Radiography (London, England : 1995)
|June 5, 2023
PubMed
Summary
This summary is machine-generated.

Establishing weight-based Diagnostic Reference Levels (DRLs) for neonatal chest radiography (CXR) is crucial for optimizing radiation doses in the neonatal intensive care unit (NICU). This study successfully derived new DRLs tailored to infant weight categories.

Keywords:
Diagnostic reference levelNeonatal chest X-rayRadiation dose

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Area of Science:

  • Medical Physics
  • Radiological Sciences
  • Pediatric Imaging

Background:

  • Neonatal intensive care unit (NICU) patients require frequent mobile chest radiography (CXR).
  • Radiation exposure in neonates raises concerns due to their sensitivity and potential for long-term health effects.
  • Existing Diagnostic Reference Levels (DRLs) may not adequately address the wide weight variations in neonates.

Purpose of the Study:

  • To establish weight-based DRLs for neonates undergoing mobile CXR in the NICU.
  • To provide benchmarks for optimizing radiation doses in this vulnerable population.
  • To ensure diagnostic image quality while minimizing radiation exposure.

Main Methods:

  • Neonates were categorized into three weight groups: <1000 g, 1000-2500 g, and >2500 g.
  • Prospective data collection of 90 neonates over three months, recording Dose-Area Product (DAP), kilovoltage (kVp), and milliampere-seconds (mAs).
  • Local DRLs (LDRLs) were derived using the median DAP, with national DRLs suggested using the 3rd quartile value.

Main Results:

  • Proposed LDRLs: 2.7 mGycm² (<1000 g), 3.7 mGycm² (1000-2500 g), and 6.6 mGycm² (>2500 g).
  • All 90 neonates received radiation doses below 11.4 mGycm².
  • 82% of DAP values were below the institution's previous LDRL of 7.25 mGycm².

Conclusions:

  • Weight-based DRLs are essential for managing radiation doses in neonates.
  • The study recommends adopting weight-based categories for DRLs in neonatal CXR.
  • These DRLs serve as a benchmark for standardizing and optimizing neonatal radiography.