Paediatric CT examinations in 19 developing countries: frequency and radiation dose

Abstract

The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.

Évaluation de la dose patient en scanographie pédiatrique dans deux hôpitaux universitaires à Yaoundé Cameroun

“…Si les efforts de l'AIEA portent des fruits avec la création d'une agence de radioprotection, la rareté des ressources contraint à la mise en oeuvre approximative des conventions internationales qui s'imposent en l'absence de cadre national (Muhogora et al, 2008(Muhogora et al, , 2010.…”

“…À l'opposé, dans les pays d'Afrique subsaharienne, les cadres législatifs et règlementaires sont soit inexistants soit mis en oeuvre de manière approximative et les pratiques de radioprotection des patients sont peu documentées alors que le parc scanographique s'accroît de manière constante depuis une décennie (Muhogora et al, 2008(Muhogora et al, , 2010Ongolo-Zogo et al, 2011). Dans le cadre d'un projet d'amélioration des pratiques de radioprotection, ce travail avait pour objectif d'évaluer, en termes dosimétriques, la pratique scanographique pédiatrique à Yaoundé au Cameroun.…”

A survey of paediatric CT radiation doses in two selected hospitals in Kampala, Uganda: a radiation safety concern

“…A study conducted in developing countries estimated an increase in pediatric CT scan examination in Africa when compared to Asia and Eastern Europe. 1 CT scan examinations have a higher effective dose 2 and yet children have increased sensitivity to radiation 3,4 . This group of patients have more life years remaining to develop cancer and as well have proportionally more growing and developing tissue and organ systems than adults which calls for a special radiation protection concern.…”

“…8 Contrary to this, studies showed a lack of awareness and malpractice leading to higher radiation doses to children. 9 Hollingsworth et al noted 20-25% of the CT scan operators did not know the scan parameters that they use for scanning children. 10 Similar findings were noted in several African countries as noted by Muhogora et al 9 All the mentioned discrepancies call for the establishment of standard operating parameters during CT scan procedure which is a major concern in pediatric patient's radiation protection.…”

Travmatik Beyin Hasarlı Çocuk Hastalarda Tekrarlayan Bilgisayarlı Tomografinin Değerliliği ve Radyasyon Hasarı

“…Different procedures about the indication, dosage of Head CT and repeated CT used common in pediatric TBI have been performed in different centers (3)(4).…”