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Pediatric Diagnostic Reference Levels for Chest X-Rays in the Northern Cape Province of South Africa: A Descriptive
O L Lackay1, J Horn-Lodewyk1,2, H Muller1
1Department of Clinical Sciences Central University of Technology Free State Bloemfontein Free State South Africa.
Insights
This study established pediatric diagnostic reference levels (PiDRLs) for AP chest X-rays in South Africa, finding doses comparable to international benchmarks. The results support optimizing radiation dose for pediatric patients, ensuring diagnostic quality and safety.
Area of Science:
- Radiological Sciences
- Medical Physics
- Pediatric Imaging
Background:
- Pediatric patients exhibit higher radiosensitivity, necessitating radiation dose optimization.
- Diagnostic Reference Levels (DRLs) are crucial for dose optimization in radiological examinations.
- Establishing pediatric DRLs (PiDRLs) is vital for safeguarding children undergoing X-rays.
Purpose of the Study:
- To establish pediatric diagnostic reference levels (PiDRLs) for anteroposterior (AP) chest X-rays.
- To assess image quality in relation to established dose levels.
- To provide baseline data for radiation dose optimization in South African pediatric imaging.
Main Methods:
- Calculated PiDRLs for 375 pediatric patients (birth to 12 years) across four hospitals.
- Categorized patients by weight bands and age groups for analysis.
- Assessed image quality using a standardized checklist to ensure diagnostic acceptability.
Main Results:
- Mean PiDRLs ranged from 0.2 to 0.3 mGy across different weight and age groups.
- The 75th percentile of dose distribution was used to determine PiDRLs.
- Image quality was consistently high and acceptable, with doses aligning with international benchmarks.
Conclusions:
- Established PiDRLs provide a baseline for dose optimization in South African pediatric radiology.
- The findings support adherence to international benchmarks for radiation safety in pediatric imaging.
- This study contributes essential regional data for improving radiation protection for children.
Background And Aims:
The International Commission on Radiological Protection emphasizes dose optimization for pediatric patients due to their higher radiosensitivity. Establishing diagnostic reference levels (DRLs) supports this goal during radiological examinations. This study aimed to establish pediatric diagnostic reference levels (PiDRLs) for anteroposterior (AP) chest X-rays across four hospitals in the Northern Cape Province, South Africa.
Methods:
PiDRLs were calculated for 375 pediatric patients (birth to 12 years) categorized by weight bands and age groups. Image quality was assessed using an image quality assessment checklist. DRLs were determined as the 75th percentile of the dose distribution for fixed X-ray units. An image quality assessment was performed to establish if the dose levels consistently produced images of acceptable diagnostic quality.
Results:
Mean PiDRLs for weight groups < 5 kg, 5- < 15 kg, 15- < 30 kg, 30- < 50 kg were 0.2 mGy, 0.2 mGy, 0.2 mGy, and 0.3 mGy, respectively. Corresponding values for age groups < 1 year, 1- < 5 years, 5- < 10 years, and 10- < 12 years were 0.2 mGy, 0.2 mGy, 0.3 mGy, and 0.3 mGy, respectively. Image quality was consistently high, with the 75th percentile slightly exceeding international benchmarks. The image quality assessment confirmed that the dose levels produced images of acceptable image quality.
Conclusion:
PiDRLs match select international benchmarks, offering a baseline for South African optimization. This study contributes valuable regional data to support radiation safety and dose optimization in pediatric medical imaging in South Africa.
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