Local diagnostic reference levels in children’s CT examinations according to the new european guidelines

Diagnostic reference levels in paediatric fluoroscopy: how does a secondary referral centre compare with 2018 European guidelines?

British Journal of Radiology ◽

10.1259/bjr.20201269 ◽

2021 ◽

pp. 20201269

Author(s):

Emily Ashworth ◽

Liam Woods ◽

J Valmai Cook

Keyword(s):

Age Groups ◽

Ionising Radiation ◽

Low Doses ◽

Age Group ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Referral Centre ◽

European Guidelines

Objectives: To compare diagnostic reference levels (DRLs) in paediatric fluoroscopy at a secondary referral centre with 2018 European guidelines. Secondly, to compare secondary referral centre DRLs for paediatric fluoroscopy examinations not included in European guidelines with 2010 national UK DRLs. Methods: Paediatric fluoroscopy studies were grouped by age (groups: 0, 1, 5, 10, 15 years) for examination type and analysed retrospectively, over a period of 14 years. DRLs were compared with European DRLs (micturating cystourethrograms (MCUs)) and 2010 UK national DRLs (contrast swallows and meals). Results: 1,586 studies were performed (49% MCUs; 31% meals; 9% swallows). For all age groups, DRLs for MCUs were lower than European DRLs by up to a factor 58 x (1 year age group: secondary referral centre DRL 12 mGycm2 vs European DRL 700 mGycm2). For contrast swallows and meals, 75th percentile doses were lower than 2010 UK national 25th percentile doses in all age groups. Conclusion: Maintaining low doses of ionising radiation is particularly important in paediatrics, and our study has found that it is possible to achieve low paediatric fluoroscopy doses in a secondary referral centre setting. Advances in knowledge: Our data may prove useful to other centres and could contribute towards future European DRLs.

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European Society of Paediatric Radiology Computed Tomography and Dose Task Force: European guidelines on diagnostic reference levels for paediatric imaging

Pediatric Radiology ◽

10.1007/s00247-019-04346-z ◽

2019 ◽

Vol 49 (5) ◽

pp. 702-705 ◽

Cited By ~ 5

Author(s):

Claudio Granata ◽

Erich Sorantin ◽

Raija Seuri ◽

Catherine M. Owens

Keyword(s):

Computed Tomography ◽

European Society ◽

Task Force ◽

Diagnostic Reference Levels ◽

Paediatric Radiology ◽

Reference Levels ◽

European Guidelines ◽

Paediatric Imaging

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

British Journal of Radiology ◽

10.1259/bjr.20210700 ◽

2021 ◽

Author(s):

Anja Almén ◽

Jónína Guðjónsdóttir ◽

Nils Heimland ◽

Britta Højgaard ◽

Hanne Waltenburg ◽

...

Keyword(s):

Data Collection ◽

Age Groups ◽

Age Group ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Actual Weight ◽

European Guidelines ◽

Number Of Patients ◽

Weight Groups ◽

Radiological Examinations

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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Diagnostic Reference Levels

Korean Society of Computed Tomographic Technology ◽

10.31320/jksct.2020.22.1.15 ◽

2020 ◽

Vol 22 (1) ◽

pp. 15-21

Author(s):

Pyong-Kon Cho

Keyword(s):

Diagnostic Reference Levels ◽

Reference Levels

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New french diagnostic reference levels: Let's take stock of our daily practices!

Journal of Neuroradiology ◽

10.1016/j.neurad.2019.08.001 ◽

2019 ◽

Vol 46 (6) ◽

pp. 341-342 ◽

Cited By ~ 3

Author(s):

Julien Ognard ◽

David Bourhis ◽

René Anxionnat ◽

Douraied Ben Salem

Keyword(s):

Diagnostic Reference Levels ◽

Reference Levels

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Diagnostic reference levels for adult’s abdominal computed tomography in a referral centre in Nigeria

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/655/1/012064 ◽

2021 ◽

Vol 655 (1) ◽

pp. 012064

Author(s):

D.Z. Joseph ◽

I.S. Mansur ◽

I. Garba ◽

M.S. Umar ◽

F.B. Nkubli ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Referral Centre ◽

Abdominal Computed Tomography

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Diagnostic Reference Levels for Common Orthopedic Hand and Wrist Procedures Using Intraoperative mini C-arm Fluoroscopy

Hand ◽

10.1177/1558944721994257 ◽

2021 ◽

pp. 155894472199425

Author(s):

Kiran R. Madhvani ◽

Matthew J. R. Clark ◽

Alex A. J. Kocheta

Keyword(s):

Radiation Dose ◽

Fracture Fixation ◽

Wrist Fracture ◽

Radiation Doses ◽

Diagnostic Reference Levels ◽

Reference Levels ◽

Audit Data ◽

Small Joint ◽

Open Fixation ◽

Phalangeal Fracture

Background: Diagnostic reference levels are radiation dose levels in medical radiodiagnostic practices for typical examinations for groups of standard-sized individuals for broadly defined types of equipment. This study aimed to contribute to national diagnostic reference levels for common hand and wrist procedures using mini C-arm fluoroscopy. Small joint and digital fracture procedure diagnostic reference levels have not been reported in significant numbers previously with procedure-level stratification. Methods: Data were collected from fluoroscopy logbooks and were cross-referenced against the audit log kept on fluoroscopy machines. A total of 603 procedures were included. Results: The median radiation dose for wrist fracture open fixation was 2.73 cGycm2, Kirschner wiring (K-wiring) procedures was 2.36 cGycm2, small joint arthrodesis was 1.20 cGycm2, small joint injections was 0.58 cGycm2, and phalangeal fracture fixation was 1.05 cGycm2. Conclusions: Wrist fracture fixation used higher radiation doses than phalangeal fracture fixation, arthrodeses, and injections. Injections used significantly less radiation than the other procedures. There are significant differences in total radiation doses when comparing these procedures in hand and wrist surgery. National and international recommendations are that institutional audit data should be collected regularly and should be stratified by procedure type. This study helps to define standards for this activity by adding to the data available for wrist fracture diagnostic reference levels and defining standards for digital and injection procedures.

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