The rarity of the tumor and unusual age of discovery have prompted us to report this case. Our case suggests that this disease can have an aggressive behavior. This is why we advise a rapid and correct diagnosis followed by an aggressive treatment.

The purpose of this study was to assess and analyze the radiation doses during head pediatric CT from different CT units within six Tunisian hospitals representing different geographic regions in order to optimize the dose given and minimize the radiology risk to this category of patients and towards the derivation of national diagnostic reference levels. Patient data and exposure parameters were collected for four age groups (<1, 1-5, 5-10 and 10-15 y). Clinical protocols and exposure settings were analyzed. Doses were collected in terms of CTDIvol and DLP values. Effective and Organ doses to specific radiosensitive organs were estimated using the Monte Carlo simulation software 'Impact CTDosimetry'. Results showed large variations in CT protocols and doses between different radiology departments. CTDIvol and DLP values demonstrated a broad range between the CT units and between the axial and helical scan techniques in the same unit. CTDI vol values were estimated to be 24.9, 31.7, 45.5 and 47.8 mGy for <1, 1-5, 5-10 and 10-15 y age groups, respectively. In term of DLP, median values were ~346, 528, 824, 897 mGy cm for the same age groups, respectively. Effective dose ranged from 1.4 to 5 mSv. Dose values were comparable with those reported in the literature. The study shows an evident need for continuous training of staff in radiation protection concepts, especially within the regional hospitals, emphasizes the importance of the production and the update of recommendations and good practice guidelines using interdisciplinary working groups and opens the way for the establishment of national DRLs.

This work focuses on the determination of the radiation doses for a total sample of 916 children, categorized in four age groups (<1,1-5, <5-10, <10-15 y) undergoing the most frequent pediatric CT scans performed in different scan facilities in Tunisia in order to establish the national Diagnostic Reference Levels (DRL). Dose evaluation concerned the dosimteric indicators: Volume Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP). The different pediatric CT protocols and practices were also evaluated. Results show large variation in doses between different radiology departments. For head scans, the respective DRLs for <1, 1-5, 5-10 and 10-15 years were 26, 38, 51 and 51 mGy for CTDIvol, and 384, 664, 873 and 978 mGy cm for DLP. For the chest, the equivalent DRLs were 8, 10, 12 and 15 mGy for CTDIvol and 118, 330, 442 and 526 mGy cm for DLP. For the abdomen, the DRLs were 9,13,19,18 CTDIvol and 353, 485,592, 1073 mGy cm for DLP. This study shows that the optimization of pediatric CT procedures should be a priority especially within the regional hospitals. The implementation of corrective actions will take place after the initial DRLs. These actions, including recommendations and guidelines to good practice, should be a joint effort of all stakeholders, including health authorities, radiation protection regulator, professional societies and universities.

Education Program, but only for advanced semesters. In the mean-time10 universities have integrated sonography into their skills labs. Here the training is done by lecturers, but also by student tutors (peer teaching). -During the past years the DEGUM (German US Society) has pushed for a stronger impact of sonography on the study curriculum. For that purpose the working group Students US Education presented and published an own curriculum proposal.The Medical School Brandenburg (MHB) is the youngest faculty of medicine in Germany (founded in 2014). Basis of teaching is a praxis oriented and module referring curriculum. A special MHB-US-Curriculum includes the US as teaching method already during the 1st academic year (anatomy, physiology). During all phases of the study sono-exercises are offered. A 2-stage course systems of several days duration, during the 2 nd and 7 th semester, is setting the frame. An US-Skills-Lap, equipped with several hands on places, provide the facility for supervised hands on training and self-study. A 2 week training periods in the 6 th academic year completes the US education, comprising 260 to 280 hours. Examinations (OSCE test) accompany the stages of the US training. -The MHB-US-Curriculum should enable http://de.pons. com/%C3%BCbersetzung/englisch-deutsch/to young doctors to use sonography immediately at the beginning of their professional activity as clinical examination method in emergency medicine and also during the following specialisation.