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

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.