Diagnostic reference levels of paediatric computed tomography examinations performed at a dedicated Australian paediatric hospital

Bibbo, Giovanni; Brown, Scott M.; Linke, Rebecca

doi:10.1111/1754-9485.12488

Cited by 17 publications

(18 citation statements)

References 21 publications

(32 reference statements)

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“…There are many studies in the world that have provided DRLs for paediatric CT, such as Italian nationwide survey (2015) [20], Australia (2016) [21], Australia (2018) [22], France (2011) [23], France (2020) [14,15], Japan (2015) [24], Germany (2016) [25], England (2018) [26], Finland (2015) [27], the results from multicentre study in California, USA (2015) [28] and the European DRL (2018) [17]. We believe that the concept of AQD that integrates image quality with dose shall be found to be meaningful and our results shall provide reference values for future studies on AQD.…”

Section: Discussionmentioning

confidence: 99%

Development of image quality related reference doses called acceptable quality doses (AQD) in paediatric CT exams in Qatar

et al. 2020

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Objectives To describe first experience of integrating assessment of image quality in paediatric X-ray computed tomography (CT) with analysis of the radiation dose indices to develop reference doses called acceptable quality dose (AQD). Methods Image quality was scored by the radiologists at a tertiary care hospital in Qatar on a scale of 0 to 4 using the recently published scoring criteria. The patients undergoing head, chest and abdomen CT were divided in different weight groups as follows: < 5 kg, 5–< 15 kg, 15–< 30 kg, 30–< 50 kg, 50–< 80 kg and > 80 kg. The images that were clinically acceptable (score of 3) were included for assessment of median values of CTDIvol and DLP to obtain AQDs in different weight groups. Results After initial training in image quality scoring of CT images of 49 patients by three radiologists, the study on 715 patients indicated 665 studies (93%) were clinically acceptable as per scoring criteria. The median CTDIvol values for the above weight groups were 16, 20, 22, 22, 27 and 27 mGy and the median DLP values for these weight groups were 271, 377, 463, 486, 568 and 570 mGy cm, respectively, for head CT. Similar values are presented for chest and abdomen CTs. Conclusions The first ever experience of starting with image quality assessment and integrating it with analysis of dose indices to obtain AQD values shall provide a workable model for others and values for comparison within the facility and in other facilities leading to optimisation. Key Points • The first study to integrate image quality assessment with analysis of patient dose indices shows feasibility for routine practice in other centres. • The values of acceptable quality dose (AQD) were provided for head, chest and abdomen CT of children divided into weight groups rather than age. They shall act as reference values for future studies. • Verification of our findings on proportional increase in exposure parameters (CTDIvol and DLP) with weight by other investigators shall be helpful.

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Section: Discussionmentioning

confidence: 99%

Development of image quality related reference doses called acceptable quality doses (AQD) in paediatric CT exams in Qatar

et al. 2020

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“…Previous research has shown that probability exists for a significant DLP variation between radiographers even in the setting of a dedicated paediatric hospital. 24 …”

Section: Discussionmentioning

confidence: 99%

“…A discrepancy in the comparison of CTDI vol and DLP values for a specific examination in a specific age category is likely because of a larger-than-expected pre-selected scan area for the particular study. 24 , 25 This and the fact that the CT brain values compared better than the CT chest and abdomen values could be a result of using age, rather than weight, as an input parameter for CT chest and abdomen examination in children. 10…”

Section: Discussionmentioning

confidence: 99%

An audit of radiation doses received by paediatric patients undergoing computed tomography investigations at academic hospitals in South Africa

Merwe

Mahomed

2020

South African Journal of Radiology

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Background: Diagnostic reference levels (DRLs) are a crucial element of auditing radiation doses in paediatric computed tomography (CT). Currently, there are no national paediatric CT DRLs in South Africa.Objectives: The aim of this article was to establish local paediatric DRLs for CT examinations at two academic hospitals and to compare paediatric CT radiation output levels with established DRLs in the developed and developing world.Method: Computed Tomography Dose Indexvolume (CTDIvol) and dose length product (DLP) values were collected from CT examinations performed at two university hospitals for patients aged 0–15 years, during 01 November 2016–30 April 2017. The 75th percentile of the data distribution was calculated for each CT examination type and age group, further categorised into routine working hours and after-hours for both hospitals and statistically compared.Results: Of the 1031 CT examinations performed, CT brain examination was the most common (755/1031; 72.23%). DLP values were increased in the after-hours categories compared to regular working hours at both hospitals. The largest increase was in the 0–1 year age group (150.56%). With the exception of CT Chest and CT abdomen in the 0–1 year age group, the CTDIvol and DLP values compared favourably to international standards.Conclusion: Most of the calculated DRLs are acceptable and internationally comparable. This likely indicates effective reduction techniques and protocols. Computed tomography body examination protocols for 0–1 year patients should be reviewed. Strategies should be implemented to limit higher doses in after-hours examinations.

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“…The paediatric patient dose data analysed here are from the examinations performed at the Women's and Children's Hospital (WCH) in Adelaide. In particular, computed tomography (CT), fluoroscopy and nuclear medicine examinations are from these modality's databases. Minimum, maximum and average effective doses have been calculated for CT, fluoroscopic, general radiographic and nuclear medicine examinations in the age groups 0 to <5 years, 5 to <10 years, 10 to <15 years and 15 to <18 years.…”

Section: Methodsmentioning

confidence: 99%

Effective doses and standardised risk factors from paediatric diagnostic medical radiation exposures: Information for radiation risk communication

Bibbo

2017

J Med Imag Rad Onc

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Introduction: In the paediatric medical radiation setting, there is no consistency on the radiation risk information conveyed to the consumer (patient/ carer). Each communicator may convey different information about the level of risk for the same radiation procedure, leaving the consumer confused and frustrated. There is a need to standardise risks resulting from medical radiation exposures. In this study, paediatric radiographic, fluoroscopic, CT and nuclear medicine examination data have been analysed to provide (i) effective doses and radiation induced cancer risk factors from common radiological and nuclear medicine diagnostic procedures in standardised formats, (ii) awareness of the difficulties that may be encountered in communicating risks to the layperson, and (iii) an overview of the deleterious effects of ionising radiation so that the risk communicator can convey with confidence the risks resulting from medical radiation exposures. Methods: Paediatric patient dose data from general radiographic, computed tomography, fluoroscopic and nuclear medicine databases have been analysed in age groups 0 to <5 years, 5 to <10 years, 10 to <15 years and 15 to <18 years to determine standardised risk factors. Results: Mean, minimum and maximum effective doses and the corresponding mean lifetime risks for general radiographic, fluoroscopic, CT and nuclear medicine examinations for different age groups have been calculated. For all examinations, the mean lifetime cancer induction risk is provided in three formats: statistical, fraction and category. Conclusion: Standardised risk factors for different radiological and nuclear medicine examinations and an overview of the deleterious effects of ionising radiation and the difficulties encountered in communicating the risks should facilitate risk communication to the patient/carer.

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Diagnostic reference levels of paediatric computed tomography examinations performed at a dedicated Australian paediatric hospital

Cited by 17 publications

References 21 publications

Development of image quality related reference doses called acceptable quality doses (AQD) in paediatric CT exams in Qatar

Development of image quality related reference doses called acceptable quality doses (AQD) in paediatric CT exams in Qatar

An audit of radiation doses received by paediatric patients undergoing computed tomography investigations at academic hospitals in South Africa

Effective doses and standardised risk factors from paediatric diagnostic medical radiation exposures: Information for radiation risk communication

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