Estimation of effective doses in pediatric X‑ray computed tomography examination

Abstract

Abstract. X-ray computed tomography (CT) images are used for diagnostic and therapeutic purposes in various medical disciplines. In Japan, the number of facilities that own diagnostic CT equipment, the number of CT examinations and the number of CT scanners increased by ~1.4-fold between 2005 and 2011. CT operators (medical radiological technologists, medical physicists and physicians) must understand the effective doses for examinations at their own institutions and carefully approach each examination. In addition, the patients undergoing the examination (as well as his/her family) must understand the effective dose of each examination in the context of the cumulative dose. In the present study, the numbers of pediatric patients (aged 0-5 years) and total patients who underwent CT at Hirosaki University Hospital (Hirosaki, Japan) between January 2011 and December 2013 were surveyed, and effective doses administered to children aged 0, 1 and 5 years were evaluated. Age-and region-specific conversion factors and dose-length products obtained from the CT scanner were used to estimate the effective doses. The numbers of CT examinations performed in 2011CT examinations performed in , 2012CT examinations performed in and 2013, respectively, of which 613 (1.2%) of the overall total involved children aged 0-5 years. The estimated effective doses per examination to children aged 0, 1 and 5 years were 6.3±4.8, 4.9±3.8 and 2.7±3.0 mSv, respectively. This large variation was attributed to several factors associated with scan methods and ranges in actual setting. In conclusion, the requirement for individual patient prospective exposure management systems and estimations of low-dose radiation exposure should be considered in light of the harmful effects of exposure.

Factors Associated with CT-Scan Repetition among Pediatrics and its Relationship with Cancer Risk: A Systematic Review and Meta-Analysis Protocol

“…This paper will determine the CT-scan repetition rate and cumulative dose among pediatric patients. For example, according to the previous study, estimated effective doses per examination to children aged 0, 1, and 5 years were 6.3 ± 4.8, 4.9 ± 3.8, and 2.7 ± 3.0 mSv respectively [19]. This study will conclude all the doses for pediatric CT scans in various papers to stronger the evidence.…”

Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: 3-Year Follow-Up Study

“…Moreover, potential risks are associated with radiation exposure especially in children [27,28]. A CT scan employed to evaluate the lower extremity torsional profile releases an average radiation dose of 0.3-0.5 mSv, which is substantially lower-around 5-15 times less-than the radiation exposure linked to pediatric abdominal and head CT scans [29,30]. Furthermore, scans targeting the arms and legs pose a lower risk of provoking conditions like leukemia and brain tumors in children below 10 years, relative to scans focused on the brain, chest, and abdomen [31].…”

Value of using adaptive statistical iterative reconstruction-V (ASIR-V) technology in pediatric head CT dose reduction

“…Based on data provided by the United Nations Scientific Committee on Effects of Atomic Radiation (UNSCEAR), it is estimated that nearly half a million patients benefit from CT examinations everyday [21]. This widespread CT utilization raised the potential radiation risks particularly in children, such as cancer risk, over-exposures, or unjustified use of imaging [7,[22][23][24][25][26][27][28][29][30][31]. This issue directed recent CT researches and innovations to radiation dose reduction methods with preservation of resulting image quality [5,8,9].…”

“…The increasing awareness of potentially harmful effects associated with radiation exposure led to optimization of CT scans according to the principle of reducing radiation doses to "as low as reasonably achievable" (ALAR A) [7,8]. This was achieved by the development of a variety of dose reduction techniques, such as tube current modulation, lowered tube voltage, adaptive beam collimation, and partial scanning.…”

“…Most of the available studies in literature declared the role of ASIR with reduction of tube voltage for radiation dose reduction and preservation of resulting CT image quality. Moreover, many studies mentioned that the use of high levels of ASIR algorithm reconstruction yields softened resulting CT images with concern that fine anatomical features may be obscured [6,7,[15][16][17][18]. However, the innovated third generation of ASIR, ASIR-V has provided better noise reduction than the older ASIR generations, with resultant better image resolution [14,19].…”