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Clinical Indication-Based Pediatric Diagnostic Reference Level Values for Abdominal Computed Tomography: A

Tebello Pitso1, Ida-Keshia Sebelego1, Henra Muller1

  • 1Department of Clinical Sciences, Faculty of Health and Environmental Sciences Central University of Technology, Free State Bloemfontein South Africa.

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Summary

This study establishes pediatric diagnostic reference levels (DRLs) for abdominal CT scans in nephroblastoma patients. Findings suggest tailoring radiation doses based on patient size and clinical indication for optimized pediatric radiation exposure.

Keywords:
computed tomographynephroblastomasize‐specific dose estimatestypical diagnostic reference level valuesweight

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Area of Science:

  • Medical Imaging
  • Radiological Physics
  • Pediatric Oncology

Background:

  • Computed tomography (CT) in children raises radiation exposure concerns due to increased sensitivity.
  • Nephroblastoma is a primary indication for pediatric abdominal CT, necessitating dose evaluation.
  • Establishing pediatric diagnostic reference levels (DRLs) is crucial for radiation safety.

Purpose of the Study:

  • To determine pediatric DRLs for contrast-enhanced abdominal CT in nephroblastoma patients.
  • To provide benchmarks for radiation dose optimization in this specific pediatric population.
  • To inform future radiation safety guidelines for pediatric CT examinations.

Main Methods:

  • Retrospective collection of CTDIvol, DLP, and patient weight for 121 nephroblastoma patients.
  • Calculation of DRLs using CTDIvol, DLP, and size-specific dose estimates (SSDE).
  • Categorization of patients into weight groups to establish group-specific DRLs.

Main Results:

  • DRLs were established for two weight groups adhering to ICRP guidelines.
  • CTDIvol DRLs ranged from 2.4 to 2.7 mGy, DLP from 78.4 to 108 mGy.cm, and SSDEsum from 4.9 to 5.6 mGy.
  • Study DRLs were lower than European Commission DRLs but higher than other international values.

Conclusions:

  • Clinical indication, body weight, and SSDE are vital for pediatric DRL development.
  • Adapting DRLs to patient size and clinical context can enhance radiation dose optimization.
  • Findings support tailored radiation dose strategies for pediatric CT abdomen examinations.