Radiation dose optimisation for conventional imaging in infants and newborns using automatic dose management software: an application of the new 2013/59 EURATOM directive

Abstract

<jats:sec><jats:title>Objective:</jats:title><jats:p> The new 2013/59 EURATOM Directive (ED) demands dosimetric optimisation procedures without undue delay. The aim of this study was to optimise paediatric conventional radiology examinations applying the ED without compromising the clinical diagnosis. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Automatic dose management software (ADMS) was used to analyse 2678 studies of children from birth to 5 years of age, obtaining local diagnostic reference levels (DRLs) in terms of entrance surface air kerma. Given local DRL for infants and chest examinations exceeded the European Commission (EC) DRL, an optimisation was performed decreasing the kVp and applying the automatic control exposure. To assess the image quality, an analysis of high-contrast resolution (HCSR), signal-to-noise ratio (SNR) and figure of merit (FOM) was performed, as well as a blind test based on the generalised estimating equations method. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> For newborns and chest examinations, the local DRL exceeded the EC DRL by 113%. After the optimisation, a reduction of 54% was obtained. No significant differences were found in the image quality blind test. A decrease in SNR (−37%) and HCSR (−68%), and an increase in FOM (42%), was observed. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> ADMS allows the fast calculation of local DRLs and the performance of optimisation procedures in babies without delay. However, physical and clinical analyses of image quality remain to be needed to ensure the diagnostic integrity after the optimisation process. </jats:p></jats:sec><jats:sec><jats:title>Advances in knowledge:</jats:title><jats:p> ADMS are useful to detect radiation protection problems and to perform optimisation procedures in paediatric conventional imaging without undue delay, as ED requires. </jats:p></jats:sec>

X-linked hypophosphatemia: Management and treatment prospects

“…The radiographs should be centered on the painful sites. In compliance with EURATOM 2013/59 directives aimed at limiting radiation exposure related to investigations (15), preference should be given to EOS ® imaging in the standing position, which diminishes patient radiation exposure by 70% to 80% compared to standard radiography. Radiographs are useful for quantifying the skeletal deformities, assessing joint alignment, diagnosing fractures and Looser zones (pseudo-fractures), and evaluating enthesopathies.…”

Estimation of dose and cancer risk to newborn from chest X-ray in South-South Nigeria: a call for protocol optimization

“…The effective dose (ED) was 740 μSv, and the estimated radiation risk from ICRP 60 report was in the range of 20.7x10 6 (Table 9).…”

“…It is however necessary that radiation dose to newborns be properly optimized with emphasis on collimation (field size) and the appropriate selection of kVp and mAs. The latter has been shown to have a significant effect on the patient dose outcome [6][7][8][9][10].…”

L’hypophosphatémie liée à l’X : prise en charge et perspectives thérapeutiques

“…Les signes d'appel rhumatologiques font généralement réaliser des radiographies; celles-ci doivent être centrées sur les zones douloureuses. Quand cela est possible, la technique EOS ® , qui a l'avantage de ne produire que 20 à 30 % de l'irradiation par rapport à un cliché standard, en position debout, doit être privilégiée, dans le respect des directives EURATOM 2013/59 destinée à limiter l'irradiation délivrée par les techniques d'investigation (15). Les radiographies permettent de quantifier les déformations du squelette, mesurer l'alignement des articulations, diagnostiquer des fractures, pseudo-fractures -ou stries de Looser -et des enthésopathies.…”