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X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
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X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

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Weight based diagnostic reference levels (DRLS) for paediatric fluoroscopic procedures: A single centre review

J Eaton1, C Udoh2, J Armstrong3

  • 1Radiology Department, Great Ormond Street Hospital, London, UK; UCL GOS Institute of Child Health, London, UK; NIHR Great Ormond Street Biomedical Research Centre, London, UK.

Radiography (London, England : 1995)
|March 22, 2025
PubMed

Insights

This study developed weight-based diagnostic reference levels (DRLs) for pediatric fluoroscopy, finding doses significantly lower than national guidelines. Weight-based DRLs are crucial for optimizing radiation safety in children.

Area of Science:

  • Radiology
  • Medical Physics
  • Pediatric Imaging

Background:

  • Radiation dose optimization is critical in pediatric fluoroscopy.
  • Existing national diagnostic reference levels (DRLs) may not adequately account for pediatric size variations.
  • Establishing weight-based DRLs is essential for accurate radiation safety assessments in children.

Purpose of the Study:

  • To establish weight-based diagnostic reference levels (DRLs) for pediatric fluoroscopic procedures.
  • To assess radiation doses in children under 50 kg undergoing fluoroscopy.
  • To compare local DRLs with existing national guidelines.

Main Methods:

  • Conducted a radiation dose survey for 859 pediatric fluoroscopic examinations.
  • Calculated local DRLs for seven common procedures, stratified by patient weight.
  • Compared local DRLs against United Kingdom National Diagnostic Reference Levels (NDRLs).

Main Results:

  • Radiation doses at the study center were consistently lower than national guidelines, averaging 16% of NDRLs.
  • Lowest doses were observed for swallowing fluoroscopy studies (3-10% of NDRLs).
  • Highest doses were recorded for micturating cystourethrograms (MCUGs) and upper gastrointestinal (GI) studies (10-42% of NDRLs).

Conclusions:

  • Weight-based DRLs are vital for enhancing radiation safety in pediatric imaging.
  • The findings advocate for the widespread adoption of weight-based DRLs in healthcare facilities.
  • Regular updates to national DRLs and reporting of pediatric dose data by weight are encouraged for optimized radiation protection.
Abstract

Keywords:
DRLDose reference levelsFluoroscopyPaediatricRadiation exposure

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