Assessment of regional pediatric computed tomography dose indices in Tamil Nadu

Saravanakumar, A; Vaideki, K; Govindarajan, KN; Jayakumar, S.; Devanand, B

doi:10.4103/0971-6203.202425

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…Comparison of DRLs for paediatric head CT for children aged 0-18 years in terms of CTDI vol (mGy) within Kenya [18], South Korea [31], Thailand [30], Turkey [20], France [26], Jordan [27], Sudan [29], Japan [23], Italy [24] and the UK [38]. , India [37], Kenya [18], Korea [31], Thailand [30], Turkey [20], France [26], Japan [23] and Italy [24]. * Reference phantom not mentioned.…”

Section: Overviewmentioning

confidence: 99%

“…However, this requirement is not always found in the literature. A specially designed phantom of 10 cm diameter was used to define DRLs for paediatric head CT in one study [37]. These various size phantoms will result in different doses, although they are exposed to same quantity of radiation [36].…”

Section: Phantom Sizementioning

confidence: 99%

“…It was evident that the majority had used a 16 cm phantom (8/9 or 88.8%). However, one study used a 10 cm diameter head phantom [37]. Although 17 studies had defined DRL for the chest region, only 13 publications mentioned the phantom size used.…”

Section: Phantom Sizementioning

confidence: 99%

“…Figure 5. Comparison of DRLs for paediatric chest CT for children aged 0-18 years in terms of CTDI vol (mGy), within Iran[40], India[37], Kenya[18], Korea[31], Thailand[30], Turkey[20], France[26], Japan[23] and Italy[24]. * Reference phantom not mentioned.…”

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confidence: 99%

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Paediatric diagnostic reference levels in computed tomography: a systematic review

et al. 2021

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This study aims to review the existing literature on diagnostic reference levels (DRLs) in paediatric computed tomography (CT) procedures and the methodologies for establishing them. A comprehensive literature search was done in the popular databases such as PubMed and Google Scholar under the key words ‘p(a)ediatric DRL’, ‘dose reference level’, ‘diagnostic reference level’ and ‘DRL’. Twenty-three articles originating from 15 countries were included. Differences were found in the methods used to establish paediatric CT DRLs across the world, including test subjects, reference phantom size, anatomical regions, modes of data collection and stratification techniques. The majority of the studies were based on retrospective patient surveys. The head, chest and abdomen were the common regions. The volume computed tomography dose index (CTDIvol) and dose–length product (DLP) were the dosimetric quantities chosen in the majority of publications. However, the size-specific dose estimate was a growing trend in the DRL concept of CT. A 16 cm diameter phantom was used by most of the publications when defining DRLs for head, chest and abdomen. The majority of the DRLs were given based on patient age, and the common age categories for head, chest and abdomen regions were 0–1, 1–5, 5–10 and 10–15 years. The DRL ranges for the head region were 18–68 mGy (CTDIvol) and 260–1608 mGy cm (DLP). For chest and abdomen regions the variations were 1.0–15.6 mGy, 10–496 mGy cm and 1.8–23 mGy, 65–807 mGy cm, respectively. All these DRLs were established for children aged 0–18 years. The wide range of DRL distributions in chest and abdomen regions can be attributed to the use of two different reference phantom sizes (16 and 32 cm), failure to follow a common methodology and inadequate dose optimisation actions. Therefore, an internationally accepted protocol should be followed when establishing DRLs. Moreover, these DRL variations suggest the importance of establish a national DRL for each country considering advanced techniques and dose reduction methodologies.

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