The article reports results from the largest international dose survey in paediatric computed tomography (CT) in 32 countries and proposes international diagnostic reference levels (DRLs) in terms of computed tomography dose index (CTDI vol) and dose length product (DLP). It also assesses whether mean or median values of individual facilities should be used. A total of 6115 individual patient data were recorded among four age groups: <1 y, >1-5 y, >5-10 y and >10-15 y. CTDIw, CTDI vol and DLP from the CT console were recorded in dedicated forms together with patient data and technical parameters. Statistical analysis was performed, and international DRLs were established at rounded 75th percentile values of distribution of median values from all CT facilities. The study presents evidence in favour of using median rather than mean of patient dose indices as the representative of typical local dose in a facility, and for establishing DRLs as third quartile of median values. International DRLs were established for paediatric CT examinations for routine head, chest and abdomen in the four age groups. DRLs for CTDI vol are similar to the reference values from other published reports, with some differences for chest and abdomen CT. Higher variations were observed between DLP values, based on a survey of whole multi-phase exams. It may be noted that other studies in literature were based on single phase only. DRLs reported in this article can be used in countries without sufficient medical physics support to identify non-optimised practice. Recommendations to improve the accuracy and importance of future surveys are provided.

With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.

In this study, we thought to estimate the radiation exposure of children undergoing multi-detector CT examinations using size-specific dose estimates (SSDE). Console-displayed volume computed tomography dose index (CTDIvol) were recorded for a total of 78 paediatric abdominal CT examinations performed in six hospitals. Measurements of the patient diameters were taken from the mid-slice location on the transverse and scout CT images. Size-specific conversion coefficients were used to translate CTDIvol to the SSDE, according AAPM Report 204. For children aged 0-1 y, CTDIvol, SSDEtrans (from transverse images) and SSDEsco (from scout images) were: 12.80 ± 16.10, 14.43 ± 13.22; and 14.37 ± 13.03 mGy; respectively. For children aged 1-5 y, CTDIvol, SSDEtrans and SSDEsco were: 12.11 ± 14.47, 18.8 ± 18.61 and 16.51 ± 13.55 mGy; respectively. The obtained doses are higher than the corresponding diagnostic reference levels. SSDE increase with patient size as results of tube current modulation and is therefore a valuable tool for dose optimisation.

The aim of this study was to update the radiation exposure for adult patients undergoing multi-slice CT (MSCT) examinations using size-specific dose estimates (SSDE). Console, displayed CTDI and scan parameters were retrospectively recorded for 423 adult patients in seven Sudanese hospitals. Patient torso diameters were measured using digital calipers on the scanner console. SSDE was determined based on transverse images (SSDE) and scout radiographs (SSDE). Size-specific conversion factors were used to translate the recorded CTDI into SSDE according to the procedure described in the American Association of Physicists in Medicine (AAPM) Report 204. In chest CT, mean CTDI SSDE and SSDE ranged: from 4.3 to 47.5 mGy (average: 12.8), 5.5 to 70.3 mGy (average: 18.6) and 5.8 to 63.5 mGy (average: 18.7), respectively. In abdominal CT, mean CTDI SSDE and SSDE ranged: from 4.0 to 74.5 mGy (average: 16), 5.5 to 152.8 mGy (average: 23.9) and 6.0 to 151.3 mGy (average: 25.21), respectively. Our study highlights the relationships between CT dose and patient dimensions measured from scout and transverse CT images. The correlations between the patient size and dose based on scout images were less significant than that based on transverse images. High dose levels and dose variations among hospitals reveal the need for standardization of scanning protocols and staff training on adoption of scanners' dose reduction techniques.

This study presents the evaluation of absorbed dose in air due to gamma-emitting nuclides from (238)U and (232)Th series, (40)K and (137)Cs and the corresponding geographical information system (GIS) predictive mapping for the Northern State. Activity concentration of (238)U, (232)Th , (40)K and (137)Cs in soil samples collected from different locations have been measured using high-resolution gamma spectrometry. On  average, activity concentrations were 19±4 ((238)U), 47±11 ((232)Th), 317±65 ((40)K) and 2.26 Bq kg(-1) for (137)Cs. Absorbed dose rate in air at a height of 1 m above ground surface was calculated using seven sets of dose rate conversion factors (DRCFs) and the corresponding annual effective dose was estimated. On average, the values obtained fall within a narrow range of 44 and 53 nGy h(-1), indicating that the variation in absorbed dose rate is insignificant for different DRCFs. The corresponding annual effective dose ranged from 53 to 65 µSv y(-1). Using GIS, prediction maps for concentrations of (238)U, (232)Th, (40)K and (137)Cs were produced. Also, a map for absorbed dose rate in air at a height of 1 m above the ground level was produced, which showed a trend of increasing from the west towards south-east of the State.