U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations

Kanal, Kalpana M.; Butler, Priscilla F.; Chatfield, Mythreyi; Wells, John G.; Samei, Ehsan; Simanowith, Michael; Golden, Dan; Gress, Dustin A.; Burleson, Judy; Sensakovic, William F.; Strauss, Keith J.; Frush, Donald P.

doi:10.1148/radiol.2021211241

Cited by 37 publications

(30 citation statements)

References 21 publications

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“…The studies of Takei et al, 8 Kanal et al, 12 and Vawda et al 15 showed that DRLs and ADs for size-based CTDIvol, SSDE, and DLP for body evaluations increased in lockstep with the patient's effective diameter. Kanal et al 12 indicated that CTDIvol was higher when facilities used a tube voltage of 120 kV as a pediatric CT scanning condition. However, using 80 to 100 kV can help reduce CTDIvol.…”

Section: Discussionmentioning

confidence: 99%

“…The age-based CTDIvol AD ranged from 19 to 46 mGy for heads without contrast material, and the DRL ranged from 23 to 55 mGy, with both AD and DRL increasing with age. Using data from the American College of Radiology Dose Index Registry, diagnostic reference values and realistic doses for the 10 most often performed CT pediatric examinations were produced as a function of patient age and effective diameter 12 …”

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confidence: 99%

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Computed Tomography Diagnostic Reference Levels for Brain, Chest, and Abdominal/Pelvis Examinations

et al. 2022

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Radiation dosage variance is one of the topics that arise when dealing with computed tomography (CT) devices within medical imaging centers. In this article, a review was done to enlighten the causes of such dosage variance and the degree of variation for pediatric patients. The article focuses on the diagnostic reference levels (DRLs) for the brain, chest, and abdomen CT images. The reviewed studies were categorized depending on the type of the cases of pediatric patients, which include head, chest, and abdominal examinations. There were 9 studies using human data, 1 with phantom data, and 2 with combined human and phantom data. The dosage indices used in the studies were the DRLs, which were used as a key comparison between studies. The classification was likewise done at the expense of the radiation dose, with a secondary classification based on the patients' age, weight, and size. The type of scanner, differences in protocols, variations in patients, and variations in research design are all considered sources of variation. The following dosage indices were found in different combinations: volume CT dose index (CTDIvol), dose length product (DLP), and size-specific dose estimate (SSDE). The use of different dose indices limited the dose comparison between 11 studies.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Computed Tomography Diagnostic Reference Levels for Brain, Chest, and Abdominal/Pelvis Examinations

et al. 2022

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“… 18–21 However, these NDRLs are for age groups or weight groups different from those proposed in the European guidelines. In a recent study performed in the USA, 22 DRL was determined for several CT examinations. However, as information about patient weight was not available in the study, age groups were converted to weight groups.…”

Section: Discussionmentioning

confidence: 99%

Paediatric diagnostic reference levels for common radiological examinations using the European guidelines

Almén

Guðjónsdóttir

Heimland

et al. 2021

The British Journal of Radiology

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Objective: The purpose of this study was to explore the feasibility to determine regional diagnostic reference levels (RDRLs) for paediatric conventional and CT examinations using the European guidelines and to compare RDRLs derived from weight and age groups, respectively. Methods: Data were collected from 31 hospitals in 4 countries, for 7 examination types for a total of 2978 patients. RDRLs were derived for each weight and age group, respectively, when the total number of patients exceeded 15. Results: It was possible to derive RDRLs for most, but not all, weight-based and age-based groups for the seven examinations. The result using weight-based and age-based groups differed substantially. The RDRLs were lower than or equal to the European and recently published national DRLs. Conclusion: It is feasible to derive RDRLs. However, a thorough review of the clinical indications and methodologies has to be performed previous to data collection. This study does not support the notion that DRLs derived using age and weight groups are exchangeable. Advances in knowledge: Paediatric DRLs should be derived using weight-based groups with access to the actual weight of the patients. DRLs developed using weight differ markedly from those developed with the use of age. There is still a need to harmonize the method to derive solid DRLs for paediatric radiological examinations.

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“…Accordingly, optimizing the radiation dose for pediatric CT is a priority. In children, CT is most frequently used for brain imaging [ 2 , 3 ], and an increased incidence of brain tumors has been reported in children who underwent brain CT [ 4 , 5 , 6 ]. Therefore, optimization of the radiation dose in pediatric brain CT is of particular importance.…”

Section: Introductionmentioning

confidence: 99%

Sample Size and Estimation of Standard Radiation Doses for Pediatric Brain CT

et al. 2022

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Estimation of the standard radiation dose at each imaging facility is required for radiation dose management, including establishment and utilization of the diagnostic reference levels. We investigated methods to estimate the standard dose for pediatric brain computed tomography (CT) using a small number of data. From 980 pediatric brain CT examinations, 25, 50, and 100 examinations were randomly extracted to create small, medium, and large datasets, respectively. The standard dose was estimated by applying grouping and curve-fitting methods for 20 datasets of each sample size. For the grouping method, data were divided into groups according to age or body weight, and the standard dose was defined as a median value in each group. For the curve-fitting methods, logarithmic, power, and bilinear functions were fitted to plots of radiation dose against age or weight, and the standard dose was calculated at the designated age or weight using the derived equation. When the sample size was smaller, the random variations of the estimated standard dose were larger. Better estimation of the standard dose was achieved with the curve-fitting methods than with the grouping method. Power fitting appeared to be more effective than logarithmic and bilinear fittings for suppressing random variation. Determination of the standard dose for pediatric brain CT by the curve-fitting method is recommended to improve radiation dose optimization at facilities performing the imaging procedure infrequently.

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U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations

Cited by 37 publications

References 21 publications

Computed Tomography Diagnostic Reference Levels for Brain, Chest, and Abdominal/Pelvis Examinations

Computed Tomography Diagnostic Reference Levels for Brain, Chest, and Abdominal/Pelvis Examinations

Paediatric diagnostic reference levels for common radiological examinations using the European guidelines

Sample Size and Estimation of Standard Radiation Doses for Pediatric Brain CT

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