Establishing Local Diagnostic Reference Levels and Reference Curves for Thorax and Abdomen-Pelvis Paediatric CT
Rokas Dastikas1, Antonio Jreije2, Birutė Gricienė3
1Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Insights
This study establishes local diagnostic reference levels (DRLs) for paediatric CT scans, finding doses generally lower than European guidelines. These DRLs aid in optimizing radiation exposure for children undergoing CT examinations.
Area of Science:
- Medical Imaging
- Radiology
- Paediatric Imaging
Background:
- Paediatric Computed Tomography (CT) scans pose radiation risks, increasing lifetime cancer risk and mortality.
- Children are especially vulnerable to ionizing radiation effects.
- Managing radiation exposure in paediatric CT is crucial.
Purpose of the Study:
- Evaluate local radiation exposure doses in paediatric thoracic and abdominal-pelvic CT exams.
- Establish Diagnostic Reference Level (DRL) curves for paediatric CT.
- Propose local DRLs and compare them with European guidelines (PiDRL).
Main Methods:
- Analysed paediatric thoracic and abdominal-pelvic CT scan data.
- Grouped patient data by weight intervals (5-79 kg).
- Calculated Volumetric Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) values; assessed dose-weight relationships using exponential curves.
Main Results:
- Established local DRLs for thoracic CT across weight groups.
- Proposed DRL curves for abdominal-pelvic CT due to limited data.
- Reported specific CTDIvol and DLP values for various paediatric weight categories.
Conclusions:
- Local DRLs for thoracic CT and median doses for abdominal-pelvic CT are generally lower than European DRLs.
- Derived DRL curves serve as effective benchmarks for dose optimization in paediatric CT.
- The study provides valuable data for radiation dose management in children.
Background:
Computed tomography is a highly informative diagnostic tool, but its use poses the challenge of managing potentially high radiation exposure to patients. Children are particularly vulnerable to the harmful effects of ionizing radiation, and the growing use of paediatric Computed Tomography (CT) scans has been linked to an elevated lifetime risk of cancer and an increased mortality. The aim of this study was to evaluate local radiation exposure doses in paediatric thoracic and abdominal-pelvic CT exams, to establish Diagnostic Reference Level (DRL) curves, propose local diagnostic reference levels, and compare them with the existing literature and the European Guidelines on Diagnostic Reference Levels for Paediatric Imaging (PiDRL).
Materials And Methods:
A dataset of thoracic and abdominal-pelvic CT exams performed on children was analysed. Scan data entries were grouped according to the patient weight in the following intervals: 5 to 14 kg, 15 to 29 kg, 30 to 49 kg, and 50 to 79 kg. In each weight group, the minimum, first quartile, median, third quartile, and the maximum values of Volumetric Computed Tomography Dose Index (CTDIvol) and the Dose Length Product (DLP) were calculated. The relationship between CTDIvol, DLP, and the patient body weight was assessed by using exponential curves.
Results:
The local DRLs were established for thoracic CT exams, while, for abdominal-pelvic CT exams, the DRL curve was set as a substitute due to limited data. The proposed local DRL values for thoracic computed tomography examinations are 2.0, 2.4, 3.6, and 5.0 mGy for CTDIvol and 40, 60, 116, and 156 mGy•cm for DLP in the corresponding weight groups of 5 to 14 kg, 15 to 29 kg, 30 to 49 kg, and 50 to 79 kg. The median values of CTDIvol for paediatric abdominal-pelvic computed tomography were 2.8 mGy in the 5-to-14 kg weight group, 3.6 mGy in the 15-to-29 kg group, 4.8 mGy in the 30-to-49 kg group, and 7.9 in the 50-to-79 kg group. The median DLP values were 81, 127, 203, and 304 mGy•cm, respectively.
Conclusions:
The set local DRLs for thoracic and the median dose values in abdominal-pelvic CT exams are generally lower than the European DRLs. The derived DRL curves fulfil the same purpose as weight-group DRLs, serving as benchmarks for dose optimization.
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