Double low protocol in pediatric abdominal CT for evaluating right lower quadrant pain

Area of Science:

• Radiology
• Pediatric Imaging
• Medical Physics

Background:

• Minimizing radiation and contrast media exposure in pediatric CT is crucial.
• The double low protocol (low contrast concentration and low tube voltage) is a potential alternative to conventional protocols.

Purpose of the Study:

• To compare the diagnostic efficacy of a double low protocol (240 mgI/ml + 80 kVp) versus a conventional protocol (350 mgI/ml + 120 kVp) in pediatric patients (<10 years) with suspected acute appendicitis.

Main Methods:

• Retrospective analysis of 121 pediatric patients undergoing enhanced abdominal CT.
• Comparison of radiation dose, iodine load, and image quality parameters between the double low (Group A) and conventional (Group B) protocols.
• Independent assessment of diagnostic image quality, appendix visualization, and diagnostic performance for appendicitis by two radiologists.

Main Results:

• The double low protocol group (Group A) showed significantly lower effective dose and iodine load compared to the conventional protocol group (Group B).
• Despite lower image quality and signal-to-noise ratio in Group A, appendix visualization and diagnostic accuracy for appendicitis were comparable between groups (98.4% vs. 94.9%).
• No significant differences were observed in patient age, body weight, or contrast media volume used.

Conclusions:

• The double low protocol is an effective alternative for enhanced abdominal CT in pediatric patients.
• This protocol achieves comparable diagnostic performance to conventional methods while significantly reducing radiation exposure.
• Findings support the adoption of safer CT acquisition practices in pediatric imaging.