Variation in Pediatric Head CT Imaging Protocols in Washington State

Kanal, Kalpana M.; Vavilala, Monica S.; Raelson, Colin; Mohan, Abhishek; Cohen, Wendy A.; Jarvik, Jeffrey G.; Rivara, Frederick P.; Stewart, Brent K.

doi:10.1016/j.jacr.2010.11.005

Cited by 25 publications

(22 citation statements)

References 26 publications

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“…Multiple different strategies have been adopted in the past in an attempt to lower the cumulative head CT radiation dose, [25][26][27][28] including decreasing the milliamperes, shielding (ie, thyroid shields, bismuth eye shields), automatic tube-current modulation, angling the gantry to exclude the orbits, and so forth. Dosereduction techniques that involve reducing the milliamperes, however, are limited by the resulting increased image noise and decreased CNR when using FBP as the reconstruction algorithm.…”

Section: Discussionmentioning

confidence: 99%

The Use of Adaptive Statistical Iterative Reconstruction in Pediatric Head CT: A Feasibility Study

Vorona

Zuccoli

Sutcavage

et al. 2012

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

The Use of Adaptive Statistical Iterative Reconstruction in Pediatric Head CT: A Feasibility Study

Vorona

Zuccoli

Sutcavage

et al. 2012

AJNR Am J Neuroradiol

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“…adults (14). Although this risk can be tempered by altering the technical parameters of the CT examination, it is uncertain whether such adjustment is commonly performed among nonpediatric radiologists or whether a mild decrease in dose per examination can mitigate the increase in the overall number of CT studies in nonpediatric settings (26,34,(43)(44)(45). Given the radiosensitivity of the solid organs, use of abdominopelvic CT merits special attention as an important contributor to the overall radiation exposure in the pediatric population (46).…”

Section: Health Policy and Practice: Pediatric Abdominal Painmentioning

confidence: 99%

Pediatric Abdominal Pain: Use of Imaging in the Emergency Department in the United States from 1999 to 2007

Hryhorczuk¹,

Mannix²,

Taylor³

2012

Radiology

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“…For children with traumatic brain injury (TBI), evidence suggests substantial variation in head CT protocols between centers that are pediatric-focused and those that are not. [12]…”

Section: Introductionmentioning

confidence: 99%

Hospital-Level Factors Associated With Use of Pediatric Radiation Dose-Reduction Protocols for Head CT: Results From a National Survey

Graves

Kanal

Vavilala

et al. 2014

Journal of the American College of Radiology

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Objectives To examine hospital-level factors associated with the use of a dedicated pediatric dose-reduction protocol and protective shielding for head CT in a national sample of hospitals. Materials and Methods A mixed-mode (online and paper) survey was administered to a stratified random sample of U.S. community hospitals (N=751). Respondents provided information on pediatric head CT scanning practices, including use of a dose-reduction protocol. Modified Poisson regression analyses describe the relative risk (RR) of not reporting the use of a pediatric dose reduction protocol or protective shielding; multivariable analyses adjust for census region, trauma level, children’s hospital status, and bed size. Results Of hospitals that were contacted, 38 were ineligible (no CT scanner, hospital closed, do not scan infants), 1 refused, and 253 responded (35.5% response rate). Across all hospitals, 92.6% reported using a pediatric dose reduction protocol. Modified Poisson regression showed that small hospitals (0–50 beds) were 20% less likely to report using a protocol than large hospitals (>150 beds) (RR: 0.80, 95% CI: 0.65–0.99; adjusted for covariates). Teaching hospitals were more likely to report using a protocol (RR: 1.10, 95% CI: 1.02–1.19; adjusted for covariates). After adjusting for covariates, children’s hospitals were significantly less likely to report using protective shielding than non-children’s hospitals (RR: 0.64, 95% CI: 0.56–0.73), though this may be due to more advanced scanner type. Conclusion Results from this study provide guidance for tailored educational campaigns and quality improvement interventions to increase the adoption of pediatric dose-reduction efforts.

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Variation in Pediatric Head CT Imaging Protocols in Washington State

Cited by 25 publications

References 26 publications

The Use of Adaptive Statistical Iterative Reconstruction in Pediatric Head CT: A Feasibility Study

The Use of Adaptive Statistical Iterative Reconstruction in Pediatric Head CT: A Feasibility Study

Pediatric Abdominal Pain: Use of Imaging in the Emergency Department in the United States from 1999 to 2007

Hospital-Level Factors Associated With Use of Pediatric Radiation Dose-Reduction Protocols for Head CT: Results From a National Survey

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