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Tesfaw AF, Dellie ST, Legesse TK, Gebremedhin YG, Seid AN. Assessment of radiation exposure among pediatric patients referred for CT imaging at three government hospitals in Addis Ababa, Ethiopia. SAGE Open Med 2024; 12:20503121241266323. [PMID: 39070015 PMCID: PMC11282509 DOI: 10.1177/20503121241266323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/19/2024] [Indexed: 07/30/2024] Open
Abstract
Background Due to the high sensitivity of their growing tissues to ionizing radiation, pediatric patients are at a greater risk of cancer development. Objective This study aimed to evaluate the level of radiation exposure experienced by pediatric patients undergoing a common CT examination at the three government hospitals in Addis Ababa, Ethiopia. Materials and methods Structured formats were designed for data collection at three government hospitals, and then information about pediatric patients' demography, CT protocols, and CT systems was retrieved and recorded from March 2018 up to July 2018. CT dose indicators: CTDIvol (mGy) and DLP (mGy.cm) values for abdomen, chest, and head CT scans were recorded based on pediatric patients' age ⩽1, (1-5], (5-10], and (10-15] years old. The data were analyzed through SPSS version 25 software. Finally, the third quartile values of CTDIvol and DLP were determined and compared with other international DRLs. Results The third quartile values of radiation dose descriptors for abdomen, chest, and head CT scans, respectively, in terms of CTDIvol (mGy): 58, 10, 17, 51; 23, 23, 34, 51; 62, 41, 50, 51; and in terms of DLP (mGy.cm), 377, 314, 624, 664; 523, 571, 406, 739; 927, 806, 929, and 1197 corresponded to pediatric patients of age ⩽1, (1-5], (5-10], and (10-15] years old, respectively. Conclusion There were significant differences in the radiation dosage of some CT examinations between the same age groups, indicating a need for dose optimization. Therefore, this study recommends the need for enhancing radiation safety, ensuring appropriate imaging practices, and prioritizing the well-being of pediatric patients who visit CT examinations in Addis Ababa, Ethiopia.
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Affiliation(s)
- Ambaye Fisehaw Tesfaw
- Department of Physics, College of Natural and Computational Sciences, Woldia University, Woldia, Ethiopia
| | - Seife Teferi Dellie
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfaye Kebede Legesse
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Abdhjelil Nijamu Seid
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Xu H, Sun QF, Yue BR, Cheng JS, Niu YT. Results and analysis of examination doses for paediatric CT procedures based on a nationwide survey in China. Eur Radiol 2024; 34:1659-1666. [PMID: 37672054 DOI: 10.1007/s00330-023-10005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/14/2023] [Accepted: 06/07/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE To report the results of a dose survey conducted across 31 provinces in mainland China from 2017 to 2018 and to analyse the dose level to determine the national diagnostic reference levels (DRLs) for paediatric CT procedures. METHODS At least ten patients for each age group (0- < 1, 1- < 5, 5- < 10, 10- < 15 years) and each procedure (head, chest and abdomen) for each CT scanner were selected from four to eight hospitals in each province. The dose information (CTDIvol and DLP) was collected from the HIS or RIS-PACS systems. The median values in each CT scanner were considered the representative dose values for the paediatric patients in CT scanning. The national DRLs were estimated based on the 75th percentile distribution of the median values. RESULTS A total of 24,395 patients and 319 CT scanners were investigated across 262 hospitals. For paediatric CT scanning in 4 different age groups, the median (P50) and the 75th percentile (P75) of CTDIvol and DLP for each scanning procedure were calculated and reported. National DRLs were then proposed for each procedure and age group. CONCLUSION The dose level of CT scanning for children in mainland China was reported for the first time. The DRLs for paediatric CT in the present study are similar to those in some Asian countries but higher than those in European countries. CLINICAL RELEVANCE STATEMENT The paediatric CT is an extensively used tool in diagnosing paediatric disease; however, children are more sensitive to radiation. Establishing the diagnostic reference level of paediatric CT examination is necessary to reduce the dose of CT in children and promote the optimisation of medical exposure. KEY POINTS • The DRLs for 3 paediatric CT procedures (head, chest and abdomen) and 4 age groups (0- < 1, 1- < 5, 5- < 10, 10- < 15 years) were proposed in mainland China first time. • The examination parameter and dose for children need to be further optimised in China, especially to lower the tube voltage in paediatric CT.
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Affiliation(s)
- Hui Xu
- Key Laboratory of Radiological Protection and Nuclear Emergency Chinese Center for Disease Control and Prevention, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, 100088, China
| | - Quan-Fu Sun
- Key Laboratory of Radiological Protection and Nuclear Emergency Chinese Center for Disease Control and Prevention, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, 100088, China.
| | - Bao-Rong Yue
- Key Laboratory of Radiological Protection and Nuclear Emergency Chinese Center for Disease Control and Prevention, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, 100088, China
| | - Jin-Sheng Cheng
- Key Laboratory of Radiological Protection and Nuclear Emergency Chinese Center for Disease Control and Prevention, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, 100088, China
| | - Yan-Tao Niu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
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A new approach to dose reference levels in pediatric CT: Age and size-specific dose estimation. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Salah H, Rabbaa M, Abuljoud M, Babikir E, Alkhorayef M, Tamam N, Tahir D, Sulieman A, Bradley DA. Paediatric effective radiation doses during brain computed tomography angiography procedure. Appl Radiat Isot 2023; 192:110610. [PMID: 36525913 DOI: 10.1016/j.apradiso.2022.110610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
In comparison to adults and paediatric are more sensitive to ionizing radiation exposure. Computed tomography (CT) is now the dominant source of medical radiologic tests for patients, accounting for more than 70% of total doses to the general public. Paediatric CT brain scans (with and without contrast) are routinely performed for a variety of clinical reasons. As a result, this parameter must be calculated in order to determine relative radiation risk. The goal of this study is to assess the radiation risk to children during CT brain diagnostic procedures. Three hundred fifty three child patients' radiation risk doses were assessed over the course of a year. The mean and ranged of the children's radiation doses were 40.6 ± 8.8 (27.8-45.8) CTDIvol (mGy) and 850 ± 230 (568.1-1126.4) DLP (mGy.cm) for the brain with contrast medium. For CT brain without contrast, the patients' doses were 40.9 ± 9.4 (14.27-64.07) CTDIvol (mGy), and 866.1 ± 289.3 (203.6-2484.9) DLP (mGy.cm). The characteristics related to the radiation dose were retrieved from the scan protocol generated by the CT system by the participating physicians after each procedure. Furthermore, optimizing the CT acquisition parameter is critical for increasing the benefit while lowering the procedure's radiogenic risk. The patients' radiation dose is comparable with the most previously published studies and international diagnostic reference levels (DRLs). Radiation dose optimization is recommended due to high sensitivity of the paediatric patients to ionizing radiation.
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Affiliation(s)
- H Salah
- INAYA Medical Collage, Nuclear Medicine Department, Riyadh, Saudi Arabia; College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum, Sudan.
| | - Mohammad Rabbaa
- Radiology Department, Riyadh Care Hospital, Riyadh, Saudi Arabia
| | | | - E Babikir
- Radiologic Technology Program, College of Health and Sport Sciences, University of Bahrain, Sakhir Campus, Zallaq, P.O. Box 32038, Bahrain
| | - M Alkhorayef
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O Box 10219, Riyadh, 11433, Saudi Arabia
| | - N Tamam
- Department of Physics, College of Sciences, Princess Nourah bint Abdulrahman University, P.O Box 84428, Riyadh, 11671, Saudi Arabia
| | - Dahlang Tahir
- Department of Physics, Hasanuddin University, Makassar, 90245, Indonesia
| | - A Sulieman
- Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O. Box 422, Alkharj, 11942, Saudi Arabia
| | - D A Bradley
- Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, United Kingdom; Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500, Bandar Sunway, Selangor, Malaysia
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Patient size as a parameter for determining Diagnostic Reference Levels for paediatric Computed Tomography (CT) procedures. Phys Med 2022; 102:55-65. [PMID: 36126468 DOI: 10.1016/j.ejmp.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The paediatric radiation dose has never been studied in Sri Lanka, nor has a national diagnostic reference level (NDRL) established. Therefore, the primary aim of this study was to propose diagnostic reference levels (DRL) and achievable dose (AD) values for paediatric CT examinations based on size. METHODS A total of 658 paediatric (0-15 years) non-contrast-enhanced (NC) studies of head, chest and abdomen regions performed during six months in two dedicated paediatric hospitals (out of the three such institutions in the country) were included. For head examinations, the dose indexes were analysed based on age, while for body examinations, both age and effective diameter (Deff) were used. The median and the third quartile of the pooled dose distribution were given as AD and NDRL, respectively. RESULTS The AD ranges for the head, chest and abdomen regions based on CTDIvol were 45.8-57.2 mGy, 2.9-10.0 mGy and 3.8-10.3 mGy. The corresponding NDRL ranges were 45.8-95.8 mGy, 3.5-14.1 mGy and 4.5-11.9 mGy. The AD ranges based on SSDEdeff and deff were 3.5-9.6 mGy and 4.1-10.3 mGy in chest and abdomen regions. The corresponding NDRL were 4.5-14.1 mGy and 6.1-10.6 mGy. CONCLUSION Other institutions can use the present study DRLs as a reference dose for paediatric CT. The AD values can be used as a baseline for target dose optimisations, reducing doses up to 90%.
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Abdou SE, Salama DH, Ahmad KA, Sallam AM, El-Sayed ESM, Talaat MS, El-Farrash RA, Vassileva J. 2021 NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR PAEDIATRIC COMPUTED TOMOGRAPHY IN EGYPT. RADIATION PROTECTION DOSIMETRY 2022; 198:423-433. [PMID: 35639601 DOI: 10.1093/rpd/ncac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To establish national diagnostic reference levels (NDRLs) for most common paediatric computed tomography (CT) examinations in Egypt. METHODS This was a prospective study that included all dedicated paediatric imaging centers in Egypt. Data from 1680 individual paediatric patients undergoing CT scanning of the head, chest and abdomen-pelvis were collected. Computed tomography dose indices were recorded, data were analysed and compared with the internationally published paediatric DRLs in14 countries. RESULTS The Egyptian NDRLs of the CTDIvol (mGy) for head, chest and abdomen-pelvis scans among four paediatric age groups were found to be (23, 27, 28, 32, 4, 5, 6, 8, 5, 6, 7, 9) mGy, respectively; and the corresponding NDRLs of the DLP (mGycm) for head, chest and abdomen-pelvis scans were found to be (345, 428, 499, 637, 67, 85, 145, 215, 97, 135, 240, 320) mGycm, respectively. There were variations in the radiation doses between CT centers and identical scanners indicating the need for dose optimization. The NDRLs of the CTDIvol (mGy) and the DLP (mGycm) values were similar to or lower than international DRLs. CONCLUSION This study summarizes the results of the first Egyptian Computed Tomography survey that provides national diagnostic reference levels for paediatric patients in Egypt. Despite the reasonable NDRLs values, the study depicted certain pros and cons concerning CT practice, and identified some problems that hinder the process of optimization as well as justification in children.
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Affiliation(s)
- Sayed E Abdou
- Ain Shams University Hospitals, Department of Radiology, Cairo 11591, Egypt
| | - Dina H Salama
- Misr University for Science and Technology and Egyptian Atomic Energy Authority, Radiology and Medical Imaging Technology Departments, Cairo 11787, Egypt
| | - Khaled A Ahmad
- Ain Shams University, Paediatric Imaging Department, Cairo 11591, Egypt
| | - Abdelsattar M Sallam
- Ain Shams University, Faculty of Science, Department of Physics, Cairo 11566, Egypt
| | | | - M S Talaat
- Ain Shams University, Faculty of Science, Department of Physics, Cairo 11566, Egypt
| | - Rania A El-Farrash
- Ain Shams University, Faculty of Medicine, Department of Pediatrics, Cairo 11591, Egypt
| | - J Vassileva
- International Atomic Energy Agency, Radiation Protection Specialists, Radiation Protection Unit of the International Atomic Energy Agency, 1400 Vienna, Austria
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Karim M, Harun H, Kayun Z, Aljewaw O, Azizan S, Rafiz N, Muhammad N. Paediatric radiation dose and cancer risk associated with body effective diameter during CT thorax examination. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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A survey of the pediatric radiation doses during multiphase abdominal computed tomography examinations. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Alzimami K, Sulieman A, Omer H, Jambi LK, Alfuraih A, Al Hossain N, Babikir E, Alkhorayef M, Khandaker MU, Bradley D. Evaluation of pediatric radiation doses in computed tomography procedures in the Kingdom of Saudi Arabia. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10
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Priyanka, Kadavigere R, Sukumar S, Pendem S. Diagnostic reference levels for computed tomography examinations in pediatric population - A systematic review. J Cancer Res Ther 2021; 17:845-852. [PMID: 34528530 DOI: 10.4103/jcrt.jcrt_945_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Computed tomography (CT) has vital role in diagnosis of various pathologies using cross sectional images. Besides the advantages of CT in pediatric radiology, radiation dose has a significant adverse effect as children are more vulnerable than adults. Establishing Diagnostic Reference levels (DRLs) will determine unusual increase in radiation doses and therefore helps in optimizing the radiation dose by maintaining optimum diagnostic image quality. The objective of the review is to explore the literature on DRLs in pediatric CT examinations and techniques that have been used to establish them. Detailed search was done in PubMed-Medline, Scopus CINAHL, Web of Science, and the Cochrane Library databases to find studies that have established DRLs for pediatric CT examinations. The Preferred Reporting Items for Systematic Review and Meta-Analyses methodology was used to assess the relevant articles. The articles which assessed DRLs in pediatric CT examinations were included. A total of 501 articles were identified, of which 21 articles were included after a detailed screening process. Our review showed increased in pediatric patient dose surveys across the world and also increased in awareness for establishing DRLS among pediatric CT examinations. The review also demonstrated wide variation in DRLs and also deviation in the scanning techniques, protocols used and categorization methods used for establishing DRLs. As the pediatric population is more sensitive to radiation, the current review emphasizes the need for optimization of protocols and international standardization for establishing DRLs to facilitate a more feasible way of comparison of dose globally across CT sites.
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Affiliation(s)
- Priyanka
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajagopal Kadavigere
- Department of Radiodiagnosis and Imaging, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suresh Sukumar
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saikiran Pendem
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Esmaeilyfard R, Samanipour A, Paknahad M. A cloud-fog software architecture for dental CBCT dose monitoring using the DICOM structured report: Automated establishment of DRL. Phys Med 2021; 89:147-150. [PMID: 34365119 DOI: 10.1016/j.ejmp.2021.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The diagnostic reference level (DRL) has been established to optimize the diagnostic methods and reduce radiation dose during radiographic examinations. The aim of this study was to present a completely new solution based on Cloud-Fog software architecture for automatic establishment of the DRL values during dental cone-beam computed tomography (CBCT) according to digital imaging and communications in medicine (DICOM) structured reports. METHODS AND MATERIALS A Cloud-Fog software architecture was used for automatic data handling. This architecture used the DICOM structured reports as a source for extracting the required information by fog devices in the imaging center. These devices transferred the derived information to the cloud server. The cloud server calculated the value of indication-based DRL in dental CBCT imaging based upon the parameters and adequate quantities of the absorbed dose. The feedback of DRL value was continuously announced to the imaging centers in 6 phases. In each phase, the level of the dose was optimized in imaging centers. RESULTS The DRL value was established for 5-specific indications, including third molar teeth (511 mGy.cm2), implant (719 mGy.cm2), form and position anomalies of the tooth (408 mGy.cm2), dentoalveolar pathologies (612 mGy.cm2), and endodontics (632 mGy.cm2). The determination of the DRL value in each phase revealed a downward trend until stabilization. CONCLUSION The new solution presented in this study makes it possible to calculate and update the DRL value nationally and automatically among all centers. Also, the results showed that this approach is successful in establishing stabilized DRL values.
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Affiliation(s)
- Rasool Esmaeilyfard
- Computer Engineering and Information Technology Department, Shiraz University of Technology, Shiraz, Iran; Health Technology Research Center, Shiraz University of Technology, Shiraz, Iran
| | - Ali Samanipour
- Computer Engineering and Information Technology Department, Shiraz University of Technology, Shiraz, Iran
| | - Maryam Paknahad
- Oral and Dental Disease Research Center, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran; Oral and Maxillofacial Radiology Department, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran.
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Zamani H, Kavousi N, Masjedi H, Omidi R, Rahbar S, Perota G, Razavi E, Zare MH, Abedi-Firouzjah R. ESTIMATION OF DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSES FOR PEDIATRIC PATIENTS IN COMMON COMPUTED TOMOGRAPHY EXAMINATIONS: A MULTI-CENTER STUDY. RADIATION PROTECTION DOSIMETRY 2021; 194:214-222. [PMID: 34244802 DOI: 10.1093/rpd/ncab093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/06/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
This study was conducted to determine first local diagnostic reference levels (DRLs) and achievable doses (ADs) for pediatric patients during the most common computed tomography (CT) procedures in Yazd province. The DRL was obtained based on volume CT dose index (CTDIvol) and dose length product (DLP) for four various age groups of children. Data were collected from the most commonly performed pediatric CT scans, including abdomen-pelvis, chest, brain and sinus examinations, at six high-loaded institutes. The patients' data (766 no.) in terms of CTDIvol and DLP were obtained from four age groups: ≤1-, 1-5-, 5-10- and 10-15-y-old. The 75th percentiles of CTDIvol and DLP were considered as DRL values and the 50th percentiles were described as ADs for those parameters. Consequently, the acquired DRLs were compared with other national and international published values. The DRLs in terms of CTDIvol for abdomen-pelvis, chest, brain and sinus examinations were 3, 8, 9 and 10 mGy; 4, 5, 5 and 5 mGy; 25, 28, 29 and 38 mGy; and 23, 24, 26 and 27 mGy for four different age groups of ≤1-, 1-5-, 5-10- and 10-15-y-old, respectively. The DRL values in terms of DLP were 75, 302, 321 and 342 mGy.cm; 109, 112, 135 and 170 mGy.cm, 352, 355, 360 and 481 mGy.cm; and 206, 211, 228 and 245 mGy.cm, respectively, for the mentioned age groups. In this study, the DRL and AD values in the brain examination were greater among the other studied regions. The DRL plays a critical role in the optimization of radiation doses delivered to patients and in improving their protection. This study provides the local DRLs and ADs for the most common pediatric CT scanning in Yazd province to create optimum situation for the clinical practice.
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Affiliation(s)
- Hamed Zamani
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
| | - Nasim Kavousi
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Masjedi
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
| | - Reza Omidi
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
| | - Shiva Rahbar
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
| | - Ghazale Perota
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
| | | | - Mohammad Hosein Zare
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
- Clinical Research Development Center of Shahid Sadoughi hospital, Shahid Sadoughi University of Medical Sciences, Yazd 8915173160, Iran
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Tahmasebzadeh A, Paydar R, Soltani-Kermanshahi M, Maziar A, Reiazi R. Lifetime attributable cancer risk related to prevalent CT scan procedures in pediatric medical imaging centers. Int J Radiat Biol 2021; 97:1282-1288. [PMID: 34096826 DOI: 10.1080/09553002.2021.1931527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE Evaluation of the organ dose in pediatric patients up to 15 years old and Estimation of lifetime attributable risk (LAR) of cancer incidence in pediatric computed tomography procedures. MATERIALS AND METHODS Data from 532 patients below 15 years old was collected and they were categorized into four age groups of <1, 1-5, 5-10, and 10-15 years old. NCICT software was used to calculate the organ dose, and LAR of cancer incidence has been estimated according to the BEIR VII report. RESULTS The highest median dose in all age groups was related to eye lens (head scan), thyroid (chest scan), and colon (abdomen-pelvic scan). The highest average LAR of cancer incidence was observed for breast cancer and colon cancer following a chest CT scan of the youngest group (<1-year-olds) [68.23 per 100,000] and abdomen-pelvic scans of the oldest group (10- to 15-year-olds) [57.30 per 100,000]. CONCLUSION This study shows that the average LAR is higher in females and it decreases with age in both genders. Although CT scan has an indispensable application in diagnosis, the patient dose should be taken into account before any examination specifically in pediatric patients.
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Affiliation(s)
- Atefeh Tahmasebzadeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Paydar
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Radiation Science, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Soltani-Kermanshahi
- Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Asghar Maziar
- Department of Radiation Science, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Reiazi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
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Bingyang B, Gang W, Zhiqing S, Li N, Zhou B, Xu S, Li D. A Preliminary Study of Personalized Head CT Scan in Pediatric Patients. Dose Response 2021; 19:1559325820985660. [PMID: 33746652 PMCID: PMC7940743 DOI: 10.1177/1559325820985660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/30/2020] [Accepted: 12/13/2020] [Indexed: 01/02/2023] Open
Abstract
Objectives: In the present study, we introduced a practical approach to quantify organ-specific radiation doses and investigated whether low-dose head circumference (HC)-based protocols for non-enhanced head computed tomography (CT) could reduce organs-specific radiation dose in pediatric patients while maintaining high image quality. Methods: A total of 83 pediatric patients were prospectively recruited. Without limits to the HC, 15 patients were selected as a convention group (CON group) and underwent non-enhanced head CT scan with standard-dose protocols (tube current-time products of 250mAs). Low-dose group (LD group), including remaining 68 pediatrics were divided into 3 subgroups based on the HC: 54.1-57.0 cm for LD200mAs group (HC-based protocols of 200mAs), 51.1-54.0 cm for LD150mAs group (HC-based protocols of 150mAs), 48.1-51.0 cm for LD100mAs group (HC-based protocols of 100mAs). Subjective and objective image quality was evaluated and measured by 2 experienced radiologists. Radimetrics was used to calculate organs-specific radiation dose, including the brain, eye lenses, and salivary glands. Results: In CON250mAs group, radiation doses in the brain and salivary glands were conversely correlated with HC, and pediatric patients with smaller HC received higher organs-specific radiation dose. Reducing tube current-time product from 250 to 100mAs could significantly reduce the organ-specific radiation dose. The subjective image quality score ≥ 3.0 is acceptable for diagnosis purposes. The signal to noise ratio (SNR) and the contrast to noise ratio (CNR) of bilateral thalamus and centrum semiovale in 3 LD subgroups were not statistically different compared with the CON group. Conclusion: Our research indicated that low-dose HC-based protocols of non-enhanced head CT scan can evidently reduce the organ-specific radiation doses, while maintaining high image quality. HC can serve as a vital tool to guide personalized low-dose head CT scan for pediatric patients.
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Affiliation(s)
| | - Wang Gang
- Third Hospital of Jilin University, Changchun, China
| | - Shao Zhiqing
- Jilin University First Hospital, Changchun, China
| | - Nan Li
- Jilin University First Hospital, Changchun, China
| | - BoXu Zhou
- Jilin University First Hospital, Changchun, China
| | - ShuJia Xu
- Jilin University First Hospital, Changchun, China
| | - Dan Li
- Jilin University First Hospital, Changchun, China
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Kamdem FE, Ngano SO, Alla Takam C, Fotue AJ, Abogo S, Fai CL. Optimization of pediatric CT scans in a developing country. BMC Pediatr 2021; 21:44. [PMID: 33472595 PMCID: PMC7816416 DOI: 10.1186/s12887-021-02498-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/10/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess scan parameters and to propose strategies to optimize the examinations of children (from 0 to 15 years old) on adult scanners in developing countries. METHODS A study was done in 2015 and 2018 on 312 pediatric patients to verify improved practices. The study of 2015 ended with proposed strategies. Dose and scan parameters were available for prospective dose analysis. These strategies were implemented in a study of 2018. RESULTS Amount the CT examinations study in this paper, the common was head trauma (90 %). For every pediatric CT scan in 2015, a kV of 120 was used in the various hospitals. The mAs ranged from 57.75 to 283.33, slice thicknesses from 1.25 to 2.5 mm and pitch from 0.525 to 1.375 mm. In the study of 2018, implementing the strategy defined in the methodology and proposed in 2015: CTDIVol decreased by 21.27 % for children < 1 year, 31.97 % for children 1-4 years, 17 % for children 5-9 years. DLP also decreased by 25.14 %, 36.29 % and 19.85 % for children < 1 year, 1-4 years and 5-9 years respectively. Children were exposed to ionizing radiation on machines designed for adults, but now the doses received by children are reduced. CONCLUSIONS The reduction of doses during the pediatric CT examination is possible with the introduction of new optimization protocols or the acquisition of a new machine with a pediatric protocol.
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Affiliation(s)
- Fotso Eddy Kamdem
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon.
| | - Samba Odette Ngano
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon.,Radiography Department, Yaoundé General Hospital, Yaoundé, Cameroon
| | - Clemence Alla Takam
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Alain Jervé Fotue
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Serge Abogo
- Department of Radiology, National Social Insurance Fund Hospital, Yaoundé, Cameroon
| | - Cornellius Lukong Fai
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon
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Tahmasebzadeh A, Paydar R, Soltani Kermanshahi M, Maziar A, Rezaei M, Reiazi R. PEDIATRIC REGIONAL DRL ASSESSMENT IN COMMON CT EXAMINATIONS FOR MEDICAL EXPOSURE OPTIMIZATION IN TEHRAN, IRAN. RADIATION PROTECTION DOSIMETRY 2020; 192:341-349. [PMID: 33338233 DOI: 10.1093/rpd/ncaa192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (<1; 1-5; 5-10 and 10-15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value < 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data.
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Affiliation(s)
- Atefeh Tahmasebzadeh
- Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Paydar
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Radiation Science Department, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Soltani Kermanshahi
- Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Asghar Maziar
- Radiation Science Department, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaei
- Department of Orthopedic, Tehran University of Medical Science, Tehran, Iran
| | - Reza Reiazi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Assessment of computed tomography radiation doses for paediatric head and chest examinations using paediatric phantoms of three different ages. Radiography (Lond) 2020; 27:332-339. [PMID: 32972850 DOI: 10.1016/j.radi.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION With the rapid development of computed tomography (CT) scanners, the assessment of the radiation dose received by the patient has become a heavily researched topic and may result in a reduction in radiation exposure risk. In this study, radiation doses were measured using three paediatric phantoms for head and chest CT examinations in Najran, Saudi Arabia. METHODS Thirteen scanners were included in the study to estimate the CT radiation doses using three phantoms representing three age groups (1-, 5-, and 10-year-old patients). RESULTS The volume CT dose index (CTDIvol) estimated for each phantom ranged from 6.56 to 41.12 mGy and 0.292 to 11.10 mGy for the head and chest examinations, respectively. The estimation of lifetime attributable risk (LAR) indicated that the cancer risk could reach approximately 0.02-0.16% per 500 children undergoing head and chest CT examinations. CONCLUSION The comparison with the published data of the European Commission (EC) and countries reported in this study revealed that the mean CTDIvol for the head examinations was within the recommended dose reference levels (DRLs). Meanwhile, chest results exceeded the international DRLs for the one-year-old phantoms, suggesting that optimisation work is required at a number of sites. IMPLICATIONS FOR PRACTICE The variation among CT doses reported in this study showed that substantial standardisation is needed.
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Muhammad NA, Abdul Karim MK, Abu Hassan H, Ahmad Kamarudin M, Ding Wong JH, Ng KH. Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia. Diagnostics (Basel) 2020; 10:E591. [PMID: 32823818 PMCID: PMC7460376 DOI: 10.3390/diagnostics10080591] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 01/27/2023] Open
Abstract
Pediatrics are more vulnerable to radiation and are prone to dose compared to adults, requiring more attention to computed tomography (CT) optimization. Hence, diagnostic reference levels (DRLs) have been implemented as part of optimization process in order to monitor CT dose and diagnostic quality. The noise index has recently been endorsed to be included as a part of CT optimization in the DRLs report. In this study, we have therefore set local DRLs for pediatric CT examination with a noise index as an indicator of image quality. One thousand one hundred and ninety-two (1192) paediatric patients undergoing CT brain, CT thorax and CT chest-abdomen-pelvis (CAP) examinations were analyzed retrospectively and categorized into four age groups; group 1 (0-1 year), group 2 (1-5 years), group 3 (5-10 years) and group 4 (10-15 years). For each group, data such as the volume-weighted CT dose index (CTDIvol), dose-length product (DLP) and the effective dose (E) were calculated and DRLs for each age group set at 50th percentile were determined. Both CT dose and image noise values between age groups have differed significantly with p-value < 0.05. The highest CTDIvol and DLP values in all age groups with the lowest noise index value reported in the 10-15 age group were found in CT brain examination. In conclusion, there was a significant variation in doses and noise intensity among children of different ages, and the need to change specific parameters to fit the clinical requirement.
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Affiliation(s)
- Nor Azura Muhammad
- Department of Physics, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (N.A.M.); (M.A.K.)
| | - Muhammad Khalis Abdul Karim
- Department of Physics, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (N.A.M.); (M.A.K.)
- Centre of Diagnostic Nuclear Imaging, Faculty of Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Hasyma Abu Hassan
- Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | - Mazliana Ahmad Kamarudin
- Department of Physics, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (N.A.M.); (M.A.K.)
| | - Jeannie Hsiu Ding Wong
- Department of Biomedical Imaging, University Malaya Medical Centre, Petaling Jaya 59100, Kuala Lumpur, Malaysia; (J.H.D.W.); (K.H.N.)
| | - Kwan Hoong Ng
- Department of Biomedical Imaging, University Malaya Medical Centre, Petaling Jaya 59100, Kuala Lumpur, Malaysia; (J.H.D.W.); (K.H.N.)
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Abdulkadir MK, Mat Rahim NAY, Mazlan NS, Daud NM, Shuaib IL, Osman ND. Dose optimisation in paediatric CT examination: Assessment on current scanning protocols associated with radiation dose. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.108740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Alkhorayef M. Survey of paediatric imaging exposure from computed tomography examinations. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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21
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Sun J, Zhang Q, Zhou Z, Jia C, Yang W, Li H, Peng Y. Optimal tube voltage for abdominal enhanced CT in children: a self-controlled study. Acta Radiol 2020; 61:101-109. [PMID: 31161944 DOI: 10.1177/0284185119847683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background The use of weight-adapted pediatric computed tomography (CT) tube voltage protocols has been suggested, but a consensus standard has not been established and clinical available studies are not sufficient. Purpose To determine the best tube voltage for low dose abdominal CT imaging in children. Material and Methods Eighty-seven cases who needed three CT exams in a 1–3-month interval between scans were enrolled (mean age = 4.69 ± 3.20 years). The three scans were performed with three different tube voltages at 80 kV, 100 kV, and 120 kV, keeping the same radiation dose and same contrast injection protocol. Patients were divided into five groups for analysis based on their body weight. The subjective image quality of the three exams were evaluated using a 4-point scale (4 being the best) for image noise and image quality. The objective evaluation in terms of CT values and standard deviation in aorta, liver, spleen, pancreas, and kidney were measured to calculate the degree of enhancement and contrast-to-noise ratio (CNR) of organs. One-way ANOVA was used to compare the subjective and objective image quality with respect to different tube voltages and different patient weights. Result The 80-kV tube voltage provided the highest overall enhancement and CNR for the entire patient population and the best objective image quality for the 6.1–28.0 kg subgroup. Conclusion Patient weight-dependent tube voltage selection maximizes image quality for abdominal enhanced CT in children. The optimal tube voltage for children with weight <28 kg is 80 kV; higher voltages should be selected for children weighing 28.1–50.0 kg.
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Affiliation(s)
- Jihang Sun
- Department of Radiology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
| | - Qifeng Zhang
- Department of Radiology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
| | - Zuofu Zhou
- Department of Radiology, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fujian, PR China
| | - Chenguang Jia
- Department of Hematology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
| | - Wei Yang
- Department of Surgery Oncology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
| | - Haoyan Li
- Department of Radiology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
| | - Yun Peng
- Department of Radiology, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China
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Mohammadbeigi A, Khoshgard K, Haghparast A, Eivazi MT. LOCAL DRLS FOR PAEDIATRIC CT EXAMINATIONS BASED ON SIZE-SPECIFIC DOSE ESTIMATES IN KERMANSHAH, IRAN. RADIATION PROTECTION DOSIMETRY 2019; 186:496-506. [PMID: 31330009 DOI: 10.1093/rpd/ncz056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 03/12/2019] [Accepted: 03/26/2019] [Indexed: 06/10/2023]
Abstract
Due to the radiosensitivity of paediatric patients to X-ray, it is necessary to survey the paediatric DRLs using size-specific dose estimates (SSDE). In the present study, we determined the local diagnostic reference levels (DRLs) for paediatric chest, head and abdomen-pelvis CT examinations and their Surview scans in Kermanshah city, Iran. For ≤1 year, 1-5 years, 5-10 years and 10-15 years the DRLs (mGy) based on SSDE were determined N/A, 6.00, 6.25, 8.27 for abdomen-pelvis, and 8.74, 7.45, 11.15, 10.45 for chest and 19.05, 18.33, 18.22, 20.14 for head examinations, respectively. The differences between body size and default phantom defined in CT scanners are significant and should be considered when determining the DRLs. Based on our findings, use of CTDIv and SSDE parameters for determining DRLs leads to significant different results in children; thus SSDE is suggested as a more accurate index than CTDIV for establishing DRLs in paediatric CT examinations.
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Affiliation(s)
- Ahmad Mohammadbeigi
- M.Sc in Medical Physics, Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Karim Khoshgard
- Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Haghparast
- Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Taghi Eivazi
- Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ekpo EU, Adejoh T, Erim AE. DOSE BENCHMARKS FOR PAEDIATRIC HEAD COMPUTED TOMOGRAPHY EXAMINATION IN NIGERIA. RADIATION PROTECTION DOSIMETRY 2019; 185:464-471. [PMID: 30916763 DOI: 10.1093/rpd/ncz036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/04/2019] [Accepted: 02/23/2019] [Indexed: 06/09/2023]
Abstract
Diagnostic reference levels (DRLs) provide benchmarks for dose optimisation. We aimed to propose DRLs for paediatric head computed tomography (CT) in Nigeria and assess if facilities adapt protocols to age-specific standardisations. Volume CT dose index (CTDIvol) and dose-length-product (DLP) of at least 20 paediatric patients per age group were extracted from 11 facilities and used to propose DRLs. Kruskal-Wallis and Median tests were used to assess the contribution of age to paediatric dose variations. CTDIvol (mGy)/DLP (mGy.cm) ranged 16-31/100-1603 (newborn), 10-92/75-4072 (1-y-old), 10-81/169-2603 (5-y-olds) and 14-86/119-3945 (≥10-y-olds). The 75th percentile CTDIvol/DLP values were 27/1040, 37/988, 48/1493 and 54/1824 for newborn, 1-y, 5-y, ≥10-y-olds, respectively. Age accounted for 18.4 and 5.3% variations in median CTDIvol and DLP, respectively. Paediatric head CT doses in Nigeria are higher than reported internationally, suggesting a need for dose optimisation interventions.
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Affiliation(s)
- Ernest Usang Ekpo
- Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Cumberland Campus, 75 East Street, Lidcombe NSW 2141, Australia
| | - Thomas Adejoh
- Department of Radiology, Nnamdi Azikiwe University Teaching Hospital, PMB 5025 Nnewi, Anambra State, Nigeria
| | - Akwa Egom Erim
- Department of Radiography and Radiological Sciences, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
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24
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Pediatric minor head injury imaging practices: results from an ESPR survey. Neuroradiology 2019; 62:251-255. [DOI: 10.1007/s00234-019-02326-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/18/2019] [Indexed: 11/26/2022]
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25
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Harbron RW, Ainsbury EA, Barnard SGR, Lee C, McHugh K, Berrington de González A, Edyvean S, Pearce MS. Radiation dose to the lens from CT of the head in young people. Clin Radiol 2019; 74:816.e9-816.e17. [PMID: 31375261 DOI: 10.1016/j.crad.2019.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 06/28/2019] [Indexed: 11/28/2022]
Abstract
AIM To determine cumulative scan frequencies and estimate lens dose for paediatric computed tomography (CT) head examinations in the context of potential cataract risk. MATERIALS AND METHODS The cumulative number of head-region CT examinations among a cohort of 410,997 children and young adults who underwent CT in the UK between 1985 and 2014 was calculated. Images from a sample of these head examinations (n=668) were reviewed to determine the level of eye inclusion. Lens dose per scan was estimated using the computer program, NCICT V1.0, for different levels of eye inclusion and exposure settings typical of past and present clinical practice. RESULTS In total 284,878 patients underwent 448,108 head-region CT examinations. The majority of patients (72%) had a single recorded head-region examination. A small subset (∼1%, n=2,494) underwent ≥10 examinations, while 0.1% (n=387) underwent ≥20. The lens was included within the imaged region for 57% of reviewed routine head examinations. In many cases, this appeared to be intentional, i.e. protocol driven. In others, there appeared to have been an attempt to exclude the eyes through gantry angulation. Estimated lens doses were 20-75 mGy (mean: 47 mGy) where the eye was fully included within the examination range and 2-7 mGy (mean: 3.1 mGy) where the lens was fully excluded. Potential cumulative lens doses ranged from ∼3 mGy to ∼4,700 mGy, with 2,335 patients potentially receiving >500 mGy. CONCLUSION The majority of young people will receive cumulative lens doses well below 500 mGy, meaning the risk of cataract induction is likely to be very small.
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Affiliation(s)
- R W Harbron
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, UK.
| | - E A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, UK
| | - S G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, UK
| | - C Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - K McHugh
- Radiology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - A Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - S Edyvean
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, UK
| | - M S Pearce
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, UK
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Rawashdeh M, Abdelrahman M, Zaitoun M, Saade C, Alewaidat H, McEntee MF. Diagnostic reference levels for paediatric CT in Jordan. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:1060-1073. [PMID: 31469115 DOI: 10.1088/1361-6498/ab3ee2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to investigate the current status of Diagnostic Reference Levels (DRLs) in paediatric CT across Jordan. The dose data for four main CT examinations (brain, chest, abdominopelvic, and chest, abdomen and pelvis (CAP)) in hospitals and imaging centres (n = 4) were measured. The volume CT dose index (CTDIvol) and Dose Length Product (DLP) values were compared within the different hospitals and age groups (<1 year, 1-4 years, 5-10 years and 11-18 years). DRLs in Jordan were compared to international DRLs. The paediatric population consisted of 1818 children; 61.4% of them were male. There were significant variations between the DRLs for each CT scanner with an up to four-fold difference in dose between hospitals. There were apparent significant differences between Jordan and other countries with the DLPs in Jordan being relatively high. However, for CTDIvol, the values in Jordan were close to those of other countries. This study confirmed variations in the CTDIvol and DLP values of paediatric CT scans in Jordan. These variations were attributed to the different protocols and equipment used. There is a need to optimise paediatric CT examinations doses in Jordan.
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Affiliation(s)
- Mohammad Rawashdeh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 222110, Jordan
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Bouaoun A, Ben Omrane L, Mogaadi M, Khomsi WD, Zidi A, Hammou A. PEDIATRIC HEAD CT EXPOSURE DOSES IN TUNISIA: A PILOT STUDY TOWARDS THE ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE LEVELS. RADIATION PROTECTION DOSIMETRY 2018; 182:241-251. [PMID: 29912455 DOI: 10.1093/rpd/ncy055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Abir Bouaoun
- University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis (ISTMT), LR13ES07 Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
| | | | | | | | - Asma Zidi
- National Center of Radiation Protection, Tunis, Tunisia
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Sulieman A, Mahmoud M, Serhan O, Alonazi B, Alkhorayef M, Alzimami K, Bradley D. CT examination effective doses in Saudi Arabia. Appl Radiat Isot 2018; 141:261-265. [DOI: 10.1016/j.apradiso.2018.07.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 06/14/2018] [Accepted: 07/10/2018] [Indexed: 11/26/2022]
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Nakada Y, Okuda Y, Tsuge T, Suzuki J, Sakamoto H, Yamamoto T, Konishi Y, Tsujimoto T, Nishiki S, Satoh T, Aoyama N, Morimoto K, Aita M, Yamashita Y, Yoshitake T, Mukai M, Yokooka Y, Yokohama N, Akahane K. AUTOMATIC ACQUISITION OF CT RADIATION DOSE DATA: USING THE DIAGNOSTIC REFERENCE LEVEL FOR RADIATION DOSE OPTIMIZATION. RADIATION PROTECTION DOSIMETRY 2018; 181:156-167. [PMID: 29425381 DOI: 10.1093/rpd/ncy003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
The present work describes that we try to construct a system that collects dose information that performed CT examination from multiple facilities and unified management. The results of analysis are compared with other National diagnostic reference level (DRL), and the results are fed back to each facility and the cause of the abnormal value is investigated for dose optimization. Medical information collected 139 144 tests from 33 CT devices in 13 facilities. Although the DRL of this study is lower than that of Japan DRL, it was higher than the DRL of each country. When collecting all the examination, it is thought that the variation of the dose due to the error other than the intended imaging site is large. In future, we should continue to collect information in order to DRL renewal and we also think that it is desirable to collect information on physique and detailed scan region as well.
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Affiliation(s)
- Yoshihiro Nakada
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
| | - Yasuo Okuda
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
| | - Tatsuya Tsuge
- Anjyou Kousei Hospital, 28 Higashikurokute, Anjyou-sho, Anjyou-shi, Aichi
| | - Jyunichi Suzuki
- Okazaki City Hospital, 3-1 Goshoai, Kouryuji-sho, Okazaki-shi, Aichi
| | - Hiroshi Sakamoto
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi
| | - Tsuyoshi Yamamoto
- Oosaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Oosaka-shi, Oosaka
| | - Yasuhiko Konishi
- Rinku General Medical Center, 2-23 Rinkuouraikita, Izumisano-shi, Osaka
| | - Takeshi Tsujimoto
- Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto-shi, Kyoto
| | - Shigeo Nishiki
- Tenri Yorozu Sodanjo Hospital, 200 Mishima-cho, Tenri-shi, Nara
| | - Toshimitsu Satoh
- Yamagata University Hospital, 2-2-2 Iidanishi, Yamagata-shi, Yamagata
| | - Nobukazu Aoyama
- University of the Ryukyus Hospital, 207 Nishihara-cho Uehara, Chutogun, Okinawa
| | - Kyohei Morimoto
- Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Hiroshima-shi, Hiroshima
| | - Masamichi Aita
- Hiroshima University Hospital, 1-2-3 Kasumi, Hiroshima-shi, Hiroshima
| | - Yusuke Yamashita
- Kumamoto Chiiki Iryo Center, 5-16-10 Honjyo, Chuo-ku, Kumamoto-shi, Kumamoto
| | | | - Masami Mukai
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
| | - Yuki Yokooka
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
| | - Noriya Yokohama
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
| | - Keiichi Akahane
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inaga-ku, Chiba-shi, Chiba
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Wagner F, Bize J, Racine D, Le Coultre R, Verdun F, Trueb PR, Treier R. Derivation of new diagnostic reference levels for neuro-paediatric computed tomography examinations in Switzerland. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:1013-1036. [PMID: 29786616 DOI: 10.1088/1361-6498/aac69c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Definition of new national diagnostic reference levels (DRLs) for volume computed tomography dose index (CTDIvol) and dose length product (DLP) for neuro-paediatric CT examinations depending on the medical indication. METHODS Paediatric cranial CT data sets acquired between January 2013 and December 2016 were retrospectively collected between July 2016 and March 2017 from eight of the largest university and cantonal hospitals that perform most of the neuro-paediatric CTs in Switzerland. A consensus review of CTDIvol and DLP was undertaken for three defined anatomical regions: brain, facial bone, and petrous bone, each with and without contrast medium application. All indications for cranial CT imaging in paediatrics were assigned to one of these three regions. Descriptive statistical analysis of the distribution of the median values for CTDIvol and DLP yielded values in the minimum, maximum, 25th percentile (1st quartile), median (2nd quartile), and 75th percentile (3rd quartile). New DRLs for neuro-paediatric CT examinations in Switzerland were based on the 75th percentiles of the distributions of the median values of all eight centres. Where appropriate, values were rounded such that the DRLs increase or at least remain constant as the age of the patient increases. RESULTS Our results revealed DRLs for CTDIvol and DLP up to 20% lower than the DRLs used so far in Switzerland and elsewhere in Europe. CONCLUSIONS This study provides Swiss neuro-paediatric CT DRL values to establish optimum conditions for paediatric cranial CT examinations. Periodic national updates of DRLs, following international comparisons, are essential.
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Affiliation(s)
- Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, University of Bern, Switzerland
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Yang K, Ganguli S, DeLorenzo MC, Zheng H, Li X, Liu B. Procedure-specific CT Dose and Utilization Factors for CT-guided Interventional Procedures. Radiology 2018; 289:150-157. [PMID: 30015583 DOI: 10.1148/radiol.2018172945] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose To present procedure-specific radiation dose metric distributions and define quantitative CT utilization factors for CT-guided interventional procedures. Materials and Methods This single-center, retrospective study collected dictation reports and radiation dose data from 9143 consecutive CT-guided interventional procedures in adult patients from 2012 to 2017. Procedures were sorted into four major interventional categories: ablation, aspiration, biopsy, and drainage, each of which was further divided into subcategories. After exclusion, a total of 8213 procedures (4391 in men and 3822 in women) were divided into 21 subcategories. The mean patient age at examination for men was 62 years ± 15 (standard deviation; age range, 19-114 years), and for women it was 61 years ± 15 (age range, 19-113 years). Distributions of dose metrics and CT usage-related parameters were analyzed by category with descriptive statistic outcomes. Quantitative CT utilization factors (which measure average CT usage) for each interventional subcategory were derived by using total scan length, acquisition count, and number of images. Results Interventional CT scans have distinctly different dose metric characteristics from diagnostic CT scans. Wide variations of dose metrics were observed among subcategories, even within the same major category. For the most frequently performed CT-guided interventional procedures within each major category, liver ablation, chest aspiration, liver biopsy, and single abdominal drainage, the median dose-length product was 2351, 657, 1175, and 1125 mGy ∙ cm, respectively. Procedure-specific CT utilization factors ranged between 0.6 and 3.6. Conclusion This study provides procedure-specific CT dose metric distributions and quantitative CT utilization factors on the basis of a large number of procedures and categorization of CT-guided interventional procedures. © RSNA, 2018.
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Affiliation(s)
- Kai Yang
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
| | - Suvranu Ganguli
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
| | - Matthew C DeLorenzo
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
| | - Hui Zheng
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
| | - Xinhua Li
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
| | - Bob Liu
- From the Division of Diagnostic Imaging Physics, Department of Radiology (K.Y., M.C.D., X.L., B.L.), and Center for Image Guided Cancer Therapy, Department of Interventional Radiology (S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and MGH Biostatistics Center, Boston, Mass (H.Z.)
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Tap NHM, Sidek MAJ, Ridzwan SFM, Selvarajah SE, Zaki FM, Hamid HA. Computed Tomography Dose in Paediatric Care: Simple Dose Estimation Using Dose Length Product Conversion Coefficients. Malays J Med Sci 2018; 25:82-91. [PMID: 30914850 PMCID: PMC6422547 DOI: 10.21315/mjms2018.25.4.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/10/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The use of multislice computed tomography (MSCT) is increasing worldwide; at the same time, there is a growing awareness of the future risk of cancer associated with greater exposure to radiation. Therefore, there is a need for an accessible method of effective dose estimation. This study aims to estimate the effective doses (EDs) of a variety of paediatric computed tomography (CT) examinations in five age groups using recently published age- and region-specific dose length products (DLPs) as effective dose conversion coefficients. METHODS A retrospective review was performed over a 12-month period. Patients were assigned to one of five age groups: neonatal, 1-, 5-, 10- and 15-years-old. Age- and region-specific conversion coefficients were applied to the DLP data displayed on the CT console in order to estimate the ED. RESULTS Over the 12-month period, there were a total of 283 CT scans, 211 of which were selected for study. The ED estimates for plain CT brain scans in neonatal, 1-, 5-, 10- and 15-yearolds were 2.5, 1.5, 1.4, 1.3 and 0.8 mSv, respectively. For the corresponding CT abdominal scans, the results were 18.8, 12.9, 7.8, 8.6 and 7.5 mSv; these were the highest values recorded. High-resolution CT (HRCT) temporal scans showed EDs of 2.9, 1.8, 1.5 and 1.1 mSv in 1-, 5-, 10- and 15-years-old, respectively. CT scans of the helical thorax had an estimated ED of 4.8, 4.2 and 7.0 mSv in 5-, 10- and 15-years-old, respectively. CONCLUSION An inverse relationship between age and effective dose was demonstrated in CT scans of the brain and abdomen/pelvis. In general, our study showed lower overall EDs compared to other centres.
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Affiliation(s)
- Nor Hanani Mohd Tap
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohamed Ariff Jaafar Sidek
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Siti Farizwana Mohd Ridzwan
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - S Elavarasi Selvarajah
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Faizah Mohd Zaki
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
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Yamazaki D, Miyazaki O, Takei Y, Matsubara K, Shinozaki M, Shimada Y, Suzuki S, Muramatsu Y. USEFULNESS OF SIZE-SPECIFIC DOSE ESTIMATES IN PEDIATRIC COMPUTED TOMOGRAPHY: REVALIDATION OF LARGE-SCALE PEDIATRIC CT DOSE SURVEY DATA IN JAPAN. RADIATION PROTECTION DOSIMETRY 2018; 179:254-262. [PMID: 29216387 DOI: 10.1093/rpd/ncx268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 11/14/2017] [Indexed: 06/07/2023]
Abstract
The objective of this research is to calculate the organ equivalent dose and effective dose from the scanning conditions at 165 centers in Japan using computed tomography (CT) Dose software and compare the results with the CT dose index volume (CTDIvol), dose length product (DLP) and size-specific dose estimates (SSDE) to validate the usefulness of SSDE. The CTDIvol and DLP were significantly lower in infants than in children (p < 0.05). No significant differences were found in the bone marrow equivalent dose and effective dose for the torso between infants and children (p > 0.05), and the bone marrow equivalent dose and effective dose for the head were higher in infants than children (p < 0.05). No significant difference was found in SSDE for the torso between infants and children (p > 0.05). Organ equivalent and effective doses for head CT scans are higher in infants than in children (I/P ratio ≥ 1). The I/P ratios of CTDIvol and DLP for chest and abdominal CT scans are also higher in Japan than in other countries. CTDIvol and DLP are not accurate when used as a dose index, and SSDE was considered suitable for dose assessment of the torso. However, for head CT in infants, a further reduction in radiation exposure is required.
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Affiliation(s)
- Daisuke Yamazaki
- Department of Radiology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | | | - Yasutaka Takei
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama701-0193, Japan
| | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Masafumi Shinozaki
- Department of Radiology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Yoshiya Shimada
- Medical Exposure Research Project, National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba263-8555, Japan
| | - Shoichi Suzuki
- Faculty of Radiological Technology, School of Health Sciences, Fujita Health University, 1-98, Dengaku-gakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yoshihisa Muramatsu
- Department of Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
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Effect of arm position, presence of medical devices, and off-centering during acquisition of scout image on automatic tube voltage selection and current modulation in pediatric chest CT. PLoS One 2018; 13:e0195807. [PMID: 29664918 PMCID: PMC5903633 DOI: 10.1371/journal.pone.0195807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/29/2018] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To evaluate the patients' morphologic factors affecting radiation dose in pediatric chest CT. MATERIALS AND METHODS From November 2013 to May 2015, 315 pediatric chest CT scans were obtained using a CT scanner, and classified into 5 groups according to the patients' age. For each age group, the chest CT scans were divided into two subgroups. A cut-off value used was the 75th percentile of size-specific dose estimates (SSDE), age-specific diagnostic reference level (DRL): less than the 75th percentile of SSDE (Group A, n = 238) and greater than the 75th percentile of SSDE (Group B, n = 77). All CT scans were performed with the same protocol using automatic tube voltage selection and current modulation techniques. The morphologic factors of the patients including body mass index (BMI), arm angles, presence of medical devices in the scan field, and degree of off-centering within the CT gantry were compared between groups A and B. RESULTS Group B showed narrower arm angles on scout and coronal reformatted images, higher frequency of the presence of devices and higher BMI than group A (P < 0.001, P < 0.001; P = 0.018, and P < 0.001, respectively). In multivariate analysis, narrower arm angles, the presence of devices on the scout images and higher BMI were independently associated with higher SSDE (P = 0.001, P = 0.037, and P < 0.001, respectively). CONCLUSIONS During acquisition of the scout images, arms-down position and the presence of medical devices were associated with a high radiation dose above age-specific DRLs in pediatric chest CT, regardless of repositioning before the actual scanning. In addition, off-centering had no clinical impact on radiation dose in the routine practice.
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Ideguchi R, Yoshida K, Ohtsuru A, Takamura N, Tsuchida T, Kimura H, Uetani M, Kudo T. The present state of radiation exposure from pediatric CT examinations in Japan-what do we have to do? JOURNAL OF RADIATION RESEARCH 2018; 59:ii130-ii136. [PMID: 29420748 PMCID: PMC5941147 DOI: 10.1093/jrr/rrx095] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/23/2017] [Indexed: 06/08/2023]
Abstract
The use of computed tomography (CT) has increased dramatically over the past several decades and has resulted in a concurrent increase in medical exposure to ionizing radiation. Several recent studies have examined the link between medical radiation and the risk of cancer, especially in children. The cancer risk associated medical exposure has not been definitively confirmed. However, we have to reduce unwarranted medical radiation exposure in pediatric patients. Justification and optimization are of great importance in order to minimize these risks, and the standardization of CT usage is essential. However, in Japan no clinical guidelines for the use of CT have been commonly agreed upon, especially in children. Furthermore, the CT-associated radiation exposure in Japan varies widely among the different facilities. Further studies based on a nationwide survey in Japan will be required in order to establish simple and useful clinical guidelines.
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Affiliation(s)
- Reiko Ideguchi
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Koji Yoshida
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | | | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University
| | - Takashi Kudo
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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Fukuyama N, Kurata A, Kawaguchi N, Tashiro R, Higaki T, Yokoi T, Tanabe Y, Nishiyama H, Itoh T, Kido T, Miyagawa M, Mochizuki T. Two-Phase Contrast Injection Protocol for Pediatric Cardiac Computed Tomography in Children with Congenital Heart Disease. Pediatr Cardiol 2018; 39:518-525. [PMID: 29214485 DOI: 10.1007/s00246-017-1782-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/22/2017] [Indexed: 01/03/2023]
Abstract
To assess a two-phase contrast injection protocol for contrast enhancement during cardiac computed tomography (CT) in children with congenital heart disease. Forty-three children (20 boys, 23 girls) of median age 13 months (range 3 days-8.3 years) and weighing ≤ 20 kg who underwent cardiac CT using a two-phase contrast injection protocol at our institution were retrospectively identified. High-pitch spiral third-generation dual-source cardiac CT (tube voltage 70 kV) was performed with a fixed delay of 60 s after contrast injection in the order of 10 mgI/kg/s (30 s), 15 mgI/kg/s (20 s), and a saline chaser (10 s). Attenuation in the inferior vena cava (IVC), superior vena cava (SVC), right atrium (RA), right ventricle (RV), pulmonary artery (PA), left atrium (LA), left ventricle (LV), and descending aorta (AO) was compared using the Steel-Dwass and Fisher's exact tests. The median (interquartile range) attenuation in the IVC, SVC, RA, RV, PA, LA, LV, and AO was 285 (264-347) Hounsfield units (HU), 416 (370-445) HU, 368 (320-388) HU, 373 (322-417) HU, 397 (330-432) HU, 425 (373-469) HU, 435 (385-468) HU, and 437 (392-491) HU, respectively (p < 0.05, IVC vs. the other anatomic sites). There was no significant difference in diagnostic success rate for attenuation > 250 HU between the IVC (41 children, 95.3%) and the other sites (43 children, 100%). A two-phase contrast injection protocol is useful for effective contrast enhancement in pediatric cardiac CT.
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Affiliation(s)
- Naoki Fukuyama
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan.
| | - Naoto Kawaguchi
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Ryo Tashiro
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takashi Higaki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takahiro Yokoi
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Hikaru Nishiyama
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Toshihide Itoh
- Research and Collaboration, Siemens Healthcare, Tokyo, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Masao Miyagawa
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan
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Journy NMY, Dreuil S, Boddaert N, Chateil JF, Defez D, Ducou-le-Pointe H, Garcier JM, Guersen J, Habib Geryes B, Jahnen A, Lee C, Payen-de-la-Garanderie J, Pracros JP, Sirinelli D, Thierry-Chef I, Bernier MO. Individual radiation exposure from computed tomography: a survey of paediatric practice in French university hospitals, 2010-2013. Eur Radiol 2018; 28:630-641. [PMID: 28836026 DOI: 10.1007/s00330-017-5001-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/12/2017] [Accepted: 07/21/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs). METHODS The survey was conducted in radiology departments of six major university hospitals in France in 2010-2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms. RESULTS CTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2-4 for most body parts, but 5-7 for abdominal examinations and 4-14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years). CONCLUSION The results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children. KEY POINTS • CTDIvol varied little with age for routine head scans. • CTDIvol was lowest in youngest children for chest or abdominal scans. • Individual and inter-department variability warrant enhanced standardisation of practices. • Recent surveys support the need for revised diagnostic reference levels. • More attention should be given to specific protocols (sinuses, neck, spine, mediastinum).
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Affiliation(s)
- Neige M Y Journy
- Laboratoire d'épidémiologie des rayonnements ionisants, Unité Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France.
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9760, USA.
| | - Serge Dreuil
- Unité d'expertise en radioprotection médicale, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France
| | - Nathalie Boddaert
- Service de radiologie pédiatrique, INSERM U1000, UMR 1163, Institut Imagine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker Enfants Malades, 149 rue de Sèvres, 75743, Paris Cedex 15, France
- PRES Sorbonne Paris, Cité Université René Descartes, 190 avenue de France, 75013, Paris, France
| | - Jean-François Chateil
- Service de radiologie et d'imagerie anténatale, de l'enfant et de la femme, Groupe Hospitalier Pellegrin, Centre Hospitalier Universitaire de Bordeaux, place Amélie Raba-Léon, 33000, Bordeaux, France
| | - Didier Defez
- Service de Physique Médicale, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Benite, France
| | - Hubert Ducou-le-Pointe
- Service de Radiologie, Hôpital d'Enfants Armand-Trousseau, 26 avenue du Dr A. Netter, 75012, Paris, France
| | - Jean-Marc Garcier
- Service de radiologie, Centre Hospitalier Universitaire Estaing, 1 place Lucie-Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - Joël Guersen
- Pôle Imagerie et Radiologie Interventionnelle, Centre Hospitalier Universitaire Gabriel Montpied, 58 rue Montalembert, 63003, Clermont Ferrand cedex 1, France
| | - Bouchra Habib Geryes
- Direction des affaires médicales, de la qualité et la relation avec les usagers, Hôpital Universitaire Necker Enfants Malades, 149 rue de Sèvres, 75743, Paris Cedex 15, France
| | - Andreas Jahnen
- Luxembourg Institute of Science and Technology (LIST), 5 avenue des Hauts-Fourneaux, L-4362, Esch/Alzette, Luxembourg, Luxembourg
| | - Choonsik Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9760, USA
| | | | - Jean-Pierre Pracros
- Service d'imagerie pédiatrique, Hôpital Femme Mère Enfants, Groupe Hospitalier Est, 59 Boulevard Pinel, 69500, Bron, France
| | - Dominique Sirinelli
- Service de radiologie pediatrique, Hôpital Clocheville, Centre Hospitalier Régional Universitaire de Tours, 49 boulevard Béranger, 37000, Tours, France
| | - Isabelle Thierry-Chef
- Section of Environment and Cancer, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon cedex 08, France
| | - Marie-Odile Bernier
- Laboratoire d'épidémiologie des rayonnements ionisants, Unité Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France
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Niiniviita H, Kiljunen T, Huuskonen M, Teperi S, Kulmala J. Dose monitoring in pediatric and young adult head and cervical spine CT studies at two emergency duty departments. Emerg Radiol 2017; 25:153-159. [PMID: 29247394 DOI: 10.1007/s10140-017-1571-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/11/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE As the number of pediatric computed tomography (CT) imaging is increasing, there is a need for real-time radiation dose monitoring and evaluation of the imaging protocols. The aim of this study was to present the imaging data, patient doses, and observations of pediatric and young adult trauma-and routine head CT and cervical spine CT collected by a dose monitoring software. METHODS Patient age, study date, imaging parameters, and patient dose as volume CT dose index (CTDIvol) and dose length product (DLP) were collected from two emergency departments' CT scanners for 2-year period. The patients were divided into four age groups (0-5, 6-10, 11-15, and 16-20 years) for statistical analysis and effective dose determination. The 75th percentile doses were evaluated to be used as local diagnostic reference levels (DRLs). RESULTS Six hundred fifteen trauma head, 318 routine head, and 592 trauma cervical spine CT studies were assessed. All mean CTDIvol values were statistically lower in hospital B (40.3 ± 12.3, 30.03 ± 11.1, and 6.9 ± 3.1 mGy, respectively) than in hospital A (53.0 ± 12.9, 43.2 ± 8.7, and 18.3 ± 7.3 mGy, respectively). Statistically significant differences were observed on scanning length between hospitals and between CTDIvol values when protocol was updated. The 75th percentiles of trauma cervical spine in hospital B can be used as local DRL. Non-optimized protocols were also revealed in hospital A. CONCLUSION Dose monitoring software offers a valuable tool for evaluating the imaging practices and finding non-optimized protocols.
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Affiliation(s)
- Hannele Niiniviita
- Department of Medical Physics, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland. .,Medical Imaging Center of Southwest Finland, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Timo Kiljunen
- Docrates Cancer Center, Saukonpaadenranta 2, 00180, Helsinki, Finland
| | - Minna Huuskonen
- Department of Radiology, Satakunta Central Hospital, Sairaalantie 3, 28500, Pori, Finland
| | - Simo Teperi
- Department of Biostatistics, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Jarmo Kulmala
- Department of Medical Physics, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
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Samei E, Li X, Frush DP. Size-based quality-informed framework for quantitative optimization of pediatric CT. J Med Imaging (Bellingham) 2017; 4:031209. [PMID: 28840168 DOI: 10.1117/1.jmi.4.3.031209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/06/2017] [Indexed: 11/14/2022] Open
Abstract
The purpose of this study was to formulate a systematic, evidence-based method to relate quantitative diagnostic performance to radiation dose, enabling a multidimensional system to optimize computed tomography imaging across pediatric populations. Based on two prior foundational studies, radiation dose was assessed in terms of organ doses, effective dose ([Formula: see text]), and risk index for 30 patients within nine color-coded pediatric age-size groups as a function of imaging parameters. The cases, supplemented with added noise and simulated lesions, were assessed in terms of nodule detection accuracy in an observer receiving operating characteristic study. The resulting continuous accuracy-dose relationships were used to optimize individual scan parameters. Before optimization, the nine protocols had a similar [Formula: see text] of [Formula: see text] with accuracy decreasing from 0.89 for the youngest patients to 0.67 for the oldest. After optimization, a consistent target accuracy of 0.83 was established for all patient categories with [Formula: see text] ranging from 1 to 10 mSv. Alternatively, isogradient operating points targeted a consistent ratio of accuracy-per-unit-dose across the patient categories. The developed model can be used to optimize individual scan parameters and provide for consistent diagnostic performance across the broad range of body sizes in children.
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Affiliation(s)
- Ehsan Samei
- Duke University Medical Center, Departments of Radiology, Physics, Biomedical Engineering, and Electrical and Computer Engineering, Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Durham, North Carolina, United States
| | - Xiang Li
- Cleveland Clinic, Imaging Institute, Section of Medical Physics, Cleveland, Ohio, United States
| | - Donald P Frush
- Duke University Medical Center, Division of Pediatric Radiology, Department of Radiology, Medical Physics Graduate Program, Durham, North Carolina, United States
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Hui PKT, Goo HW, Du J, Ip JJK, Kanzaki S, Kim YJ, Kritsaneepaiboon S, Lilyasari O, Siripornpitak S. Asian consortium on radiation dose of pediatric cardiac CT (ASCI-REDCARD). Pediatr Radiol 2017; 47:899-910. [PMID: 28435986 DOI: 10.1007/s00247-017-3847-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 01/17/2017] [Accepted: 03/22/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND With incremental utilization of pediatric cardiac CT in congenital heart disease, it is imperative to define its current radiation dose levels in clinical practice in order to help imagers optimize CT protocols, particularly in Asia and other developing countries where CT physicists are not readily available. OBJECTIVE To evaluate current radiation dose levels and influencing factors in cardiac CT in children with congenital heart disease in Asia by conducting a retrospective multi-center, multi-vendor study. MATERIALS AND METHODS We included 1,043 pediatric cardiac CT examinations performed in 8 centers between January 2014 and December 2014 to evaluate congenital heart disease. In five weight groups, we calculated radiation dose metrics including volume CT dose index, size-specific dose estimate, dose-length product and effective dose. Age at CT exam, gender, tube voltage, scan mode, CT indication and image reconstruction algorithm were analyzed to learn whether they influenced CT radiation dose. RESULTS Volume CT dose index, size-specific dose estimate, dose-length product and effective dose of pediatric cardiac CT showed variations in the range of 4.3-23.8 mGy, 4.9-17.6 mGy, 55.8-501.3 mGy∙cm and 1.5-3.2 mSv, respectively, within five weight groups. Gender, tube voltage, scan mode and cardiac function assessment significantly influenced CT radiation dose. CONCLUSION This multi-center, multi-vendor study demonstrated variations in radiation dose metrics of pediatric cardiac CT reflecting current practice in Asia. Gender, tube voltage, scan mode and cardiac function assessment should be considered as essential radiation dose-influencing factors in developing optimal pediatric cardiac CT protocols.
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Affiliation(s)
- Peter K T Hui
- Department of Radiology, Hong Kong Baptist Hospital, Hong Kong, SAR, China
| | - Hyun Woo Goo
- Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea.
| | - Jing Du
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Janice J K Ip
- Department of Radiology, Queen Mary Hospital, Hong Kong, SAR, China
| | - Suzu Kanzaki
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Young Jin Kim
- Department of Radiology, Yonsei University, Shinchon Severance Hospital, Seoul, South Korea
| | - Supika Kritsaneepaiboon
- Department of Radiology, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Thailand
| | - Oktavia Lilyasari
- Department of Cardiology, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
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Kim M, Chang K, Hwang J, Nam Y, Han D, Yoon J. RADIATION DOSE FOR PEDIATRIC AND YOUNG ADULT CT: A SURVEY TO ESTABLISH AGE-BASED REFERENCE LEVELS OF 2015-2016 IN KOREA. RADIATION PROTECTION DOSIMETRY 2017; 175:228-237. [PMID: 27886991 DOI: 10.1093/rpd/ncw289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/14/2016] [Indexed: 06/06/2023]
Abstract
To assess the doses delivered to pediatric patients during computed tomography (CT) examinations of the brain, chest, high-resolution lung and abdomen, and to establish diagnostic reference levels (DRLs) for various age groups in Korea. Dose survey was done to the 19 hospitals performing CT on children, addressing the scan parameters, volume CT dose index (CTDIvol) and dose length product (DLP). Per five age group (0, 1, 2-5, 6-10, 11-17 y of age), the proposed DRLs for brain, chest, high-resolution lung and abdomen CT are, respectively, in terms of CTDIvol: 18, 23, 26, 31, 36 mGy; 2, 3, 4, 6, 8 mGy; 2, 3, 4, 5, 7 mGy; 3, 4, 5, 6, 9 mGy; and in terms of DLP: 260, 350, 420, 500, 620 mGy•cm; 50, 80, 100, 170, 340 mGy•cm; 30, 40, 60, 90, 280 mGy•cm; 70, 80, 200, 300, 500 mGy•cm. Compared with published DRLs our suggestion for pediatric CT dose is the lower end. However, an optimization process should be initiated to reduce the spread in patient dose among hospitals despite same CT protocols shown in the study. A major element of this process should be the establishment of institution performance standard and the use of built DRLs.
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Affiliation(s)
- MoonChan Kim
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - KwangHyun Chang
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - JeongHoon Hwang
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - YoonChul Nam
- Department of Radiology, Samsung Medical Center, Seoul, Korea
| | - DongKyoon Han
- Department of Radiologic Science, Eulji University, KyungKi, Korea
| | - Joon Yoon
- Department of Radiologic Science, Dongnam Health College, KyungKi, Korea
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Kim SY, Kim HS, Park MH, Lee JH, Oh SH, Chang SO, Kim CS, Jung AY, Kim YH. Optimal use of CT imaging in pediatric congenital cholesteatoma. Auris Nasus Larynx 2017; 44:266-271. [DOI: 10.1016/j.anl.2016.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/06/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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Strauss KJ, Goske MJ, Towbin AJ, Sengupta D, Callahan MJ, Darge K, Podberesky DJ, Frush DP, Maxfield C, Westra SJ, Prince JS, Wu H, Bhargavan-Chatfield M. Pediatric Chest CT Diagnostic Reference Ranges: Development and Application. Radiology 2017; 284:219-227. [PMID: 28212059 DOI: 10.1148/radiol.2017161530] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine diagnostic reference ranges on the basis of the size of a pediatric patient's chest and to develop a method to estimate computed tomographic (CT) scanner-specific mean size-specific dose estimates (SSDEs) as a function of patient size and the radiation output of each CT scanner at a site. Materials and Methods The institutional review boards of each center approved this retrospective, HIPAA-compliant, multicenter study; informed consent was waived. CT dose indexes (SSDE, volume CT dose index, and dose length product) of 518 pediatric patients (mean age, 9.6 years; male patients, 277 [53%]) who underwent CT between July 1, 2012, and June 30, 2013, according to the guidelines of the Quality Improvement Registry in CT Scans in Children were retrieved from a national dose data registry. Diagnostic reference ranges were developed after analysis of image quality of a subset of 111 CT examinations to validate image quality at the lower bound. Pediatric dose reduction factors were calculated on the basis of SSDEs for pediatric patients divided by SSDEs for adult patients. Results Diagnostic reference ranges (SSDEs) were 1.8-3.9, 2.2-4.5, 2.7-5.1, 3.6-6.6, and 5.5-8.4 mGy for effective diameter ranges of less than 15 cm, 15-19 cm, 20-24 cm, 25-29 cm, and greater than or equal to 30 cm, respectively. The fractions of adult doses (pediatric dose reduction factors) used within the consortium for patients with lateral dimensions of 8, 11, 14, 17, 20, 23, 26, 29, 32, 35, and 38 cm were 0.29, 0.33, 0.38, 0.44, 0.50, 0.58, 0.66, 0.76, 0.87, 1.0, and 1.15, respectively. Conclusion Diagnostic reference ranges developed in this study provided target ranges of pediatric dose indexes on the basis of patient size, while the pediatric dose reduction factors of this study allow calculation of unique reference dose indexes on the basis of patient size for each of a site's CT scanners. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Keith J Strauss
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Marilyn J Goske
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Alexander J Towbin
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Debapriya Sengupta
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Michael J Callahan
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Kassa Darge
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Daniel J Podberesky
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Donald P Frush
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Charles Maxfield
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Sjirk J Westra
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Jeffrey S Prince
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Huimin Wu
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
| | - Mythreyi Bhargavan-Chatfield
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229-3026 (K.J.S., M.J.G., A.J.T.); American College of Radiology National Radiology Data Registries, American College of Radiology, Reston, Va (D.S., M.B.C.); Department of Radiology, Boston Children's Hospital, Boston, Mass (M.J.C.); Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (K.D.); Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, Fla (D.J.P.); Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (D.P.F., C.M.); Section of Pediatric Radiology, Massachusetts General Hospital, Boston, Mass (S.J.W.); Department of Radiology, Primary Children's Hospital, Salt Lake City, Utah (J.S.P.); and Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, Ohio (H.W.)
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Martine RJ, Santangelo T, Colas L, Jean-Baptiste F, Duhamel A, Deschildre A, Remy J. Radiation dose levels in pediatric chest CT: experience in 499 children evaluated with dual-source single-energy CT. Pediatr Radiol 2017; 47:161-168. [PMID: 27830296 DOI: 10.1007/s00247-016-3731-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 09/24/2016] [Accepted: 10/07/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND The availability of dual-source technology has introduced the possibility of scanning children at lower kVp with a high-pitch mode, combining high-speed data acquisition and high temporal resolution. OBJECTIVE To establish the radiation dose levels of dual-source, single-energy chest CT examinations in children. MATERIALS AND METHODS We retrospectively recorded the dose-length product (DLP) of 499 consecutive examinations obtained in children <50 kg, divided into five weight groups: group 1 (<10 kg, n = 129); group 2 (10-20 kg, n = 176); group 3 (20-30 kg, n = 99), group 4 (30-40 kg, n = 58) and group 5 (40-49 kg, n = 37). All CT examinations were performed with high temporal resolution (75 ms), a high-pitch mode and a weight-adapted selection of the milliamperage. RESULTS CT examinations were obtained at 80 kVp with a milliamperage ranging between 40 mAs and 90 mAs, and a pitch of 2.0 (n = 162; 32.5%) or 3.0 (n = 337; 67.5%). The mean duration of data acquisition was 522.8 ± 192.0 ms (interquartile range 390 to 610; median 490). In the study population, the mean CT dose index volume (CTDIvol32) was 0.83 mGy (standard deviation [SD] 0.20 mGy; interquartile range 0.72 to 0.94; median 0.78); the mean DLP32 was 21.4 mGy.cm (SD 9.1 mGy.cm; interquartile range 15 to 25; median 19.0); and the mean size-specific dose estimate (SSDE) was 1.7 mGy (SD 0.4 mGy; interquartile range 1.5 to 1.9; median 1.7). The DLP32, CTDIvol32 and SSDE were found to be statistically significant in the five weight categories (P < 0.0001). CONCLUSION This study establishes the radiation dose levels for dual-source, single-kVp chest CT from a single center. In the five weight categories, the median values varied 15-37 mGy.cm for the DLP32, 0.78-1.25 mGy for the CTDIvol32 and 1.6-2.1 mGy for the SSDE.
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Affiliation(s)
- Remy-Jardin Martine
- Department of Thoracic Imaging, Hospital Calmette, CHU Lille (EA 2694) University of Lille, F-59000, Lille, France.
| | - Teresa Santangelo
- Department of Thoracic Imaging, Hospital Calmette, CHU Lille (EA 2694) University of Lille, F-59000, Lille, France.,Department of Imaging, Bambino Gesù Children's Hospital, Rome, Italy
| | - Lucie Colas
- Department of Thoracic Imaging, Hospital Calmette, CHU Lille (EA 2694) University of Lille, F-59000, Lille, France
| | - Faivre Jean-Baptiste
- Department of Thoracic Imaging, Hospital Calmette, CHU Lille (EA 2694) University of Lille, F-59000, Lille, France
| | - Alain Duhamel
- Department of Biostatistics; CHU Lille, University of Lille (EA 2694) , F-59000, Lille, France
| | - Antoine Deschildre
- Department of Pediatric Pulmonology,, CHU Lille - University of Lille, Lille, France
| | - Jacques Remy
- Department of Thoracic Imaging, Hospital Calmette, CHU Lille (EA 2694) University of Lille, F-59000, Lille, France
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Furuya K, Akiyama S, Nambu A, Suzuki Y, Hasebe Y. A Method for the Automatic Exposure Control in Pediatric Abdominal CT: Application to the Standard Deviation Value and Tube Current Methods by Using Patient's Age and Body Size. Nihon Hoshasen Gijutsu Gakkai Zasshi 2017; 73:33-41. [PMID: 28111396 DOI: 10.6009/jjrt.2017_jsrt_73.1.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We aimed to apply the pediatric abdominal CT protocol of Donnelly et al. in the United States to the pediatric abdominal CT-AEC. Examining CT images of 100 children, we found that the sectional area of the hepatic portal region (y) was strongly correlated with the body weight (x) as follows: y=7.14x + 84.39 (correlation coefficient=0.9574). We scanned an elliptical cone phantom that simulates the human body using a pediatric abdominal CT scanning method of Donnelly et al. in, and measured SD values. We further scanned the same phantom under the settings for adult CT-AEC scan and obtained the relationship between the sectional areas (y) and the SD values. Using these results, we obtained the following preset noise factors for CT-AEC at each body weight range: 6.90 at 4.5-8.9 kg, 8.40 at 9.0-17.9 kg, 8.68 at 18.0-26.9 kg, 9.89 at 27.0-35.9 kg, 12.22 at 36.0-45.0 kg, 13.52 at 45.1-70.0 kg, 15.29 at more than 70 kg. From the relation between age, weight and the distance of liver and tuber ischiadicum of 500 children, we obtained the CTDIvol values and DLP values under the scanning protocol of Donnelly et al. Almost all of DRL from these values turned out to be smaller than the DRL data of IAEA and various countries. Thus, by setting the maximum current values of CT-AEC to be the Donnelly et al.'s age-wise current values, and using our weight-wise noise factors, we think we can perform pediatric abdominal CT-AEC scans that are consistent with the same radiation safety and the image quality as those proposed by Donnelly et al.
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Affiliation(s)
- Ken Furuya
- Department of Radiology, Municipal Kofu Hospital
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46
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de Jesus FM, Magalhães LAG, Kodlulovich S. PAEDIATRIC CT EXPOSURE PRACTICE IN THE COUNTY OF RIO DE JANEIRO: THE NEED TO ESTABLISH DIAGNOSTIC REFERENCE LEVELS. RADIATION PROTECTION DOSIMETRY 2016; 171:389-397. [PMID: 26410769 DOI: 10.1093/rpd/ncv414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/24/2015] [Accepted: 08/28/2015] [Indexed: 06/05/2023]
Abstract
A pilot study of dose indicators in paediatric computed tomography (CT) was conducted to prove the need to establish diagnostic reference levels (DRLs) for the county of Rio de Janeiro. The dose descriptors were estimated from the beam dosimetry by applying the protocols used in each examination. The total patient sample included 279 children. Regarding the comparison of the dose-length product values among the hospitals, the high-resolution chest CT scans were distinguished among the three types of examinations, due to the discrepancies of 1148 % (1-5 y age group) and 2248 % (5-10 y age group) presented in Hospital A's dose-length product values relative to Hospital D's dose-length product values. The results showed that without DRL, the dose variation can be significant between hospitals in the same county for the same age group in the same examination.
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Affiliation(s)
- Fillipe M de Jesus
- Laboratório de Ciências Radiológicas (LCR), Departamento de Biofísica e Biometria, Universidade do Estado do Rio de Janeiro (UERJ), Rua São Francisco Xavier, 524, Pavilhão Haroldo Lisboa da Cunha, CEP 20550-900, Rio de Janeiro, RJ, Brazil
| | - Luis A G Magalhães
- Laboratório de Ciências Radiológicas (LCR), Departamento de Biofísica e Biometria, Universidade do Estado do Rio de Janeiro (UERJ), Rua São Francisco Xavier, 524, Pavilhão Haroldo Lisboa da Cunha, CEP 20550-900, Rio de Janeiro, RJ, Brazil
| | - Simone Kodlulovich
- Sede, Comissão Nacional de Energia Nuclear (CNEN), Rua General Severiano, 90, CEP 22290-901, Rio de Janeiro, RJ, Brazil
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47
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Almohiy H, Alasar EMM, Saade C. Correct Patient Centering Increases Image Quality without Concomitant Increase of Radiation Dose during Adult Intracranial Computed Tomography. J Med Imaging Radiat Sci 2016; 47:235-242. [DOI: 10.1016/j.jmir.2016.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 12/19/2022]
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Dovales ACM, da Rosa LAR, Kesminiene A, Pearce MS, Veiga LHS. Patterns and trends of computed tomography usage in outpatients of the Brazilian public healthcare system, 2001-2011. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:547-560. [PMID: 27460769 DOI: 10.1088/0952-4746/36/3/547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
While the patterns and trends of computed tomography (CT) are well documented in developed countries, relatively little is known about CT usage in developing countries, including Brazil. We evaluated CT usage among outpatients from the public healthcare system in Brazil (SUS), which is the unique healthcare provider to about 75% of the Brazilian population. We collected the annual number of CT procedures and type of CT examinations performed in SUS for the period 2001-2011. Age at examination was evaluated for 2008-2011. CT usage in Brazil has more than tripled during the study period, but the most striking annual increase (17.5%) was observed over the years 2008-2011. Head was the most frequently examined region for all age groups, but a decreasing trend of proportional contribution of head CT, with a simultaneous increase of abdomen/pelvis and chest CT over time was observed. CT examination for pediatric and young adult patients was about 13% of all CTs (9% if we considered age-standardized CT rates). CT usage has grown rapidly in Brazil and may still be increasing. Increased CT usage may certainly be associated with improved patient care. However, given the high frequency of pediatric and young adult CT procedures and the suggested associated cancer risk, efforts need to be undertaken to reduce unwarranted CT scans in Brazil.
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Affiliation(s)
- Ana C M Dovales
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Av. Salvador Allende, Barra da Tijuca, Rio de Janeiro, RJ, 22783-127, Brazil
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Abstract
BACKGROUND The radiation dose delivered from computed tomography (CT) scanning and the risks associated with ionising radiation are major concerns in paediatric imaging. Compared to adults, children have increased organ sensitivity and a longer expected lifetime in which cancer may develop. Therefore, it is important to investigate the awareness of paediatricians (referring physicians) regarding radiation doses and the associated risks. METHODS A multiple-choice survey was distributed among paediatricians in 8 hospitals in Riyadh, the capital of Saudi Arabia. RESULTS Among the 162 respondents, only 24 (15 %) were aware of the As Low As Reasonably Achievable (ALARA) principle. Approximately half (54 %) of the respondents believed that multi-slice CT delivered a low radiation dose, and 100 (62 %) of the respondents were not aware that radiation is considered carcinogenic by the Food and Drug Administration in the United States. Among the respondents, 110 (68 %) did not have any specific education regarding radiation during their training. There was an overall underestimation (83 %) of the CT radiation dose, and 70 % thought that magnetic resonance imaging (MRI) delivered some level of ionising radiation. CONCLUSIONS Among paediatricians in Saudi Arabian hospitals, there was a wide underestimation of the CT radiation dose and the associated risks for children. We should improve paediatricians' knowledge about radiation doses. Radiologists, paediatricians, radiation technologists and medical physicists should work together to optimise CT guidelines and protocols to reduce the radiation risks for children.
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Affiliation(s)
- Tamader Y Al-Rammah
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O.Box 10219, Riyadh, 11433, Kingdom of Saudi Arabia.
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Bibbo G, Brown S, Linke R. Diagnostic reference levels of paediatric computed tomography examinations performed at a dedicated Australian paediatric hospital. J Med Imaging Radiat Oncol 2016; 60:475-84. [DOI: 10.1111/1754-9485.12488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/23/2016] [Indexed: 01/21/2023]
Affiliation(s)
- Giovanni Bibbo
- SA Medical Imaging; Women's and Children's Hospital; North Adelaide South Australia Australia
| | - Scott Brown
- SA Medical Imaging; Women's and Children's Hospital; North Adelaide South Australia Australia
| | - Rebecca Linke
- SA Medical Imaging; Women's and Children's Hospital; North Adelaide South Australia Australia
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