Patient size as a parameter for determining Diagnostic Reference Levels for paediatric Computed Tomography (CT) procedures

Satharasinghe, Duminda; Jeyasugiththan, Jeyasingam; Wanninayake, W.M.N.M.B.; Pallewatte, Aruna; Samarasinghe, R.A.N.K.K.

doi:10.1016/j.ejmp.2022.09.004

Cited by 7 publications

(4 citation statements)

References 46 publications

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“…ADs for paediatric CT were also put forward in this survey. Unlike DRLs which is to avoid the patients from unnecessary exposure, ADs can serve as a benchmark for dose optimisation given that 50% of the doses can be lower than ADs in medical practice [18]. ADs can provide greater optimisation potential for CT doses, and a 60% reduction in average dose was achievable in this survey if ADs were followed.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the CTDI vol and DLP based on DRLs, the concept of size-specific dose estimates (SSDEs) [19] which consider the size of paediatric patients has been used to estimate the dose of CT in many countries, as a new method to summarise the DRLs of paediatric CT [10][11][12]. Recently, some studies in Asia have also indicated that patient size as a factor may better reflect dose levels [18,[20][21][22][23][24][25][26][27]. The method of SSDE may can be introduced into the further study.…”

Section: Discussionmentioning

confidence: 99%

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Age-based diagnostic reference levels and achievable doses for paediatric CT: a survey in Shanghai, China

Yang,

Gao

2024

J. Radiol. Prot.

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Computed tomography (CT) is extensively utilized in medical diagnostics due to its notable radiographic superiority. However, the cancer risk associated with CT examinations, particularly in children, is of significant concern. The assessment of cancer risk relies on the radiation dose to examinees. Diagnostic reference levels (DRLs) and achievable doses (ADs) were used to assess the level of radiation dose in CT examinations widely. Although the national DRLs of pediatric CT have been explored in China, few local DRLs at the city level have been assessed. To set up the local DRLs and ADs of pediatric CT, we investigated the radiation dose level for pediatric CT in Shanghai. In this survey, a total of 3 061 pediatric CT examinations underwent in Shanghai in 2022 were selected by stratified sampling, and the dose levels in terms of volume CT dose index (CTDIvol) and the dose-length product (DLP) were analyzed by 4 age groups. The DRLs and ADs were set at the 75th and 50th percentile of the distribution and compared with the previous studies at home and abroad. The survey results revealed that, for head scan,theDRLs of CTDIvol were from 25 to 46 mGy, and the levels of DLP were from 340 to 663 mGy·cm. For chest, the DRLs of CTDIvol were from 2.2 to 8.3 mGy, and the levels of DLP were from 42 to 223 mGy·cm. For abdomen, the DRLs of CTDIvol were from 6.3 to 16 mGy, and the levels of DLP were from 181 to 557 mGy·cm. The ADs were about 60 percent lower than their corresponding DRLs. The levels of radiation doses in children-based hospitals were higher than those in other medical institutions. (P<0.001).In conclusion, there was still potential for reducing radiation dose of pediatric CT, emphasizing the urgent need for optimizing pediatric CT dose in Shanghai.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age-based diagnostic reference levels and achievable doses for paediatric CT: a survey in Shanghai, China

Yang,

Gao

2024

J. Radiol. Prot.

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“…Due to patient shape and size difference, the above metrics are not sufficient to accurately estimate the actual patient dose. Specifically, the doses of patients smaller than the standard acrylic phantoms are underestimated 18–20 . This leads to an underestimation of the dose for average‐sized adults and paediatric by 40–70% 21 .…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, the doses of patients smaller than the standard acrylic phantoms are underestimated. 18 , 19 , 20 This leads to an underestimation of the dose for average‐sized adults and paediatric by 40–70%. 21 To address this concern, conversion factors to acquire size‐specific dose estimates (SSDEs) for specific patients have been suggested.…”

Section: Introductionmentioning

confidence: 99%

Introducing fitting models for estimating age‐specific dose and effective dose in paediatric patients undergoing head, chest and abdomen–pelvis imaging protocols: a patient study

Deevband,

Mohammadi,

Salimi

et al. 2024

J of Medical Radiation Sci

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IntroductionConcerns regarding the adverse consequences of radiation have increased due to the expanded application of computed tomography (CT) in medical practice. Certain studies have indicated that the radiation dosage depends on the anatomical region, the imaging technique employed and patient‐specific variables. The aim of this study is to present fitting models for the estimation of age‐specific dose estimates (ASDE), in the same direction of size‐specific dose estimates, and effective doses based on patient age, gender and the type of CT examination used in paediatric head, chest and abdomen–pelvis imaging.MethodsA total of 583 paediatric patients were included in the study. Radiometric data were gathered from DICOM files. The patients were categorised into five distinct groups (under 15 years of age), and the effective dose, organ dose and ASDE were computed for the CT examinations involving the head, chest and abdomen–pelvis. Finally, the best fitting models were presented for estimation of ASDE and effective doses based on patient age, gender and the type of examination.ResultsThe ASDE in head, chest, and abdomen–pelvis CT examinations increases with increasing age. As age increases, the effective dose in head and abdomen–pelvis CT scans decreased. However, for chest scans, the effective dose initially showed a decreasing trend until the first year of life; after that, it increases in correlation with age.ConclusionsBased on the presented fitting model for the ASDE, these CT scan quantities depend on factors such as patient age and the type of CT examination. For the effective dose, the gender was also included in the fitting model. By utilising the information about the scan type, region and age, it becomes feasible to estimate the ASDE and effective dose using the models provided in this study.

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Establishing national paediatric computed tomography diagnostic reference levels in Ghana

Shirazu,

Sackey,

Edziah

et al. 2024

Health Technol.

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Patient size as a parameter for determining Diagnostic Reference Levels for paediatric Computed Tomography (CT) procedures

Cited by 7 publications

References 46 publications

Age-based diagnostic reference levels and achievable doses for paediatric CT: a survey in Shanghai, China

Age-based diagnostic reference levels and achievable doses for paediatric CT: a survey in Shanghai, China

Introducing fitting models for estimating age‐specific dose and effective dose in paediatric patients undergoing head, chest and abdomen–pelvis imaging protocols: a patient study

Establishing national paediatric computed tomography diagnostic reference levels in Ghana

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