Key factors in the optimization of paediatric X-ray practice

Abstract

Justification of radiological requests, standardization of procedures and optimization of protection measures are key principles in the protection of individuals exposed to ionizing radiation for diagnostic purposes. Nowhere is this more pertinent than in the imaging of children and, following the recent introduction of the Ionising Radiation (Medical Exposure) Regulations, there is now a regulatory requirement for diagnostic radiology departments to demonstrate compliance with these principles. A study was undertaken to compare all aspects of paediatric radiological practice at two specialist and two non-specialist centres. An initial study involved analysis of nearly 3000 patient doses. The second phase of the project involved assessment of referral criteria, radiographic technique and approximately 100 radiographs at each centre by two consultant paediatric radiologists. While all radiographs were found to be diagnostically acceptable, major differences in technique were evident, reflecting the disparity in experience between staff at the specialist and non-specialist centres. The large number of sub-optimum films encountered at the latter suggests that there is a need for specific training of less experienced radiographic and clinical staff.

Unintentional exposure of neonates to conventional radiography in the Neonatal Intensive Care Units

“…It is important to try to minimize the number of radiation-producing tests, to examine the exposure dose and regularly review and implement dose reduction methods. [11][12][13][17][18][19] A dedicated professional team should be established in every NICU to monitor quality control of X-ray radiology and to educate the NICU and radiology teams.…”

Pediatric radiation protection

“…It is estimated that about 20% of all pediatric CT examinations have questionable indications [26,27]. Common language and close cooperation between referring clinicians and radiologists, as well as availability of good, practical guidelines [28], constitute essential steps in the optimization process, as they can help to limit the number of unnecessary exposures.…”

“…The quality assurance program should also perform regular tests to all machinery involved with the delivery of radiation burden, and should organize audits to ensure that DRL are kept regarding diagnostic tests in pediatrics as well as in all imaging procedures involving radiation exposure. All departments can benefit from audits and re-evaluation and standardization of their procedures [28,50,51,52,53].…”

Preliminary study on the practice of gonad shielding during pelvic radiography

“…The analysis showed direct relationship between the dose and risk of developing any solid cancer. Patient radio sensitivity was heavily dependent on age at the time of exposure, with children at greater risk of developing future radiationinduced cancer than adults [3].…”