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Evaluation of paediatric head CT radiation dose in Jordan: A new national diagnostic reference level survey
S F Hamedat1, Y Md Radzi2, M D Salman3
1School of Physics, Universiti Sains Malaysia, 11700 Gelugor, Penang, Malaysia; Diagnostic Radiology Department, Al-Bashir Hospital, Amman 11118, Jordan.
Insights
Jordanian pediatric CT scans show significant radiation dose variability. Establishing national diagnostic reference levels (DRLs) is crucial for optimizing radiation safety and ensuring consistent imaging practices for children.
Area of Science:
- Medical Imaging
- Radiology
- Pediatric Health
Background:
- Pediatric head CT scans are vital for diagnosing neurological conditions in children.
- Children are more sensitive to ionizing radiation, increasing risks from CT scans.
- Jordan lacks standardized national diagnostic reference levels (DRLs), leading to inconsistent radiation doses across hospitals.
Purpose of the Study:
- To evaluate radiation dose variability in pediatric head CT examinations across Jordanian hospitals.
- To establish initial diagnostic reference levels (DRLs) for pediatric head CT in Jordan.
- To identify areas for improvement in radiation safety practices.
Main Methods:
- A retrospective multicenter study analyzed 1550 pediatric head CT scans from eight Jordanian hospitals (February-November 2024).
- Patients were categorized into four age groups: <1, 1-5, 5-10, and 10-15 years.
- Radiation dose metrics (CTDIvol, DLP) were collected, and DRLs were determined using the 75th percentile, with age-based categories due to data limitations.
Main Results:
- Significant variations in CTDIvol and DLP were observed among hospitals and age groups.
- Median DLP for infants (<1 year) ranged from 409.6 to 550.9 mGy cm.
- Hospitals B and D exhibited higher radiation levels, while Hospitals F and H consistently showed lower doses.
Conclusions:
- There is an urgent need for national dose standardization in pediatric CT imaging in Jordan.
- Establishing local DRLs, benchmarked against international standards, is essential for safe and consistent pediatric CT practices.
- Enhanced training for radiology staff and protocol standardization are recommended to improve radiation safety.
Introduction:
Paediatric head CT scans are essential for diagnosing various neurological conditions. However, they pose radiation risks due to children's heightened sensitivity to ionizing radiation. The absence of standardized national dose-response lines (DRLs) in Jordan contributes to considerable dose variability across hospitals.
Methods:
This retrospective multicenter study evaluated 1550 pediatric head CT examinations performed between February and November 2024 in eight Jordanian hospitals. Patients were grouped into four age categories: <1, 1-5, 5-10, and 10-15 years. Radiation dose metrics, including CTDIvol and DLP, were collected. DRLs were established based on the 75th percentile of dose distributions. Statistical analysis was performed using SPSS to assess inter-hospital variability. DRLs were established using age-based categories, as patient weight data were not consistently available across hospitals, which is acknowledged as a methodological limitation.
Results:
Substantial differences in CTDIvol and DLP values were observed across hospitals and age groups. For infants (<1 year), median DLP values ranged from 409.6 to 550.9 mGy cm. Hospitals B and D recorded the highest radiation levels, while Hospitals F and H consistently reported lower values across all age groups.
Conclusion:
The findings highlight an urgent need for national dose standardization in pediatric CT imaging in Jordan. Establishing local DRLs based on international benchmarks is critical to ensure safe and consistent practices.
Implications For Practice:
This study underscores the need to improve radiation safety in paediatric CT imaging across Jordan. Radiology staff should receive ongoing training in paediatric dose optimization, including the use of age- and size-specific protocols, automated exposure control, and iterative or deep learning reconstruction techniques. Furthermore, implementing protocol standardization and national regulatory oversight will help ensure adherence to safe radiation practices.
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