scholarly journals Local Diagnostic Reference Levels for Paediatric Head CT Procedures

2021 ◽  
Vol 28 (2) ◽  
pp. 13
Author(s):  
Birutė Gricienė ◽  
Monika Šiukšterytė
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Age Groups ◽  
Ionising Radiation ◽  
Dose Assessment ◽  
Published Data ◽  
Publication Date ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Head Ct

 Background. Patients, especially children, are exposed to substantially high doses of ionising radiation during computed tomography (CT) procedures. Children are several times more susceptible to ionising radiation than adults. Diagnostic reference levels (DRLs) are an important tool for monitoring and optimising patient radiation exposure from radiological procedures. The aim of this study is to estimate the ionising radiation exposure doses and set local DRLs for head CT examinations according to age and to compare local DRLs with national and European DRLs and with literature data in other countries.Materials and methods. Scan parameters of single-phase head CT examinations were collected. Patients were grouped by age in the following intervals: <1, 1−5, 5−10, 10−15 and 15−18 years. Local age-based DRLs set as the 3rd quartile of the median dose-length product (DLP) were calculated. Literature analysis was performed on PubMed search engine on inclusion criteria: publication date 2015–2020, used keywords paediatric computed tomography, paediatric CT, diagnostic reference levels (DRLs). The 23 articles discussing paediatric DRLs were further analysed.Results. Data was collected from 194 paediatric head CT examinations performed in 2019. The median DLP values for head CT were 144.3, 233.7, 246.4, 288.9, 315.5 for <1, 1−5, 5−10, 10−15 and 15−18 years old groups. Estimated local DRLs for head CT examinations are 170, 300, 310, 320, 360 mGy*cm for <1, 1−5, 5−10, 10−15 and 15−18 years age groups respectively and 130, 210, 275, 320 mGy*cm for 0−3 months, 3 months−1 year, 1−6 years and ≥ 6 years age groups respectively.Conclusions. Results of this study showed that settled new local DRLs of head CT examinations were 2–4 times lower than national DRLs and about 2 times lower than European DRLs. Moreover, the study indicated that paediatric head CT doses are significantly lower in comparison with those indicated in the majority of published data from other hospitals over the last 6 years. Patient dose assessment and local DRLs establishment plays important role in future exposure optimisation.

scholarly journals Diagnostic reference levels for paediatric computed tomography

2015 ◽  
Vol 19 (2) ◽  
Author(s):  
Zakariya Vawda ◽  
Richard Pitcher ◽  
John Akudugu ◽  
Willem Groenewald
Keyword(s):  
Computed Tomography ◽  
Age Groups ◽  
Ct Scanning ◽  
Ct Scans ◽  
Tertiary Level ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Head Ct ◽  
Institutional Review

Objectives: To establish local diagnostic reference levels (LDRLs) for emergency paediatric head computed tomography (CT) scans performed at a South African (SA) tertiary-level hospital and to compare these with published data.Materials and methods: A retrospective analysis was conducted of volume-based CT dose index (CTDIvol) and dose length product (DLP) data from uncontrasted paediatric head CT scans performed in the Trauma and Emergency Unit of a tertiary-level SA hospital from January to June 2013. A random sample of 30 patients in each of 3 age groups (0–2, >2–5 and >5–10 years) was used. LDRL values were compared with several national DRLs from Europe and Australia. Results: Mean CTDIvol and DLP values were: 30 mGy and 488 mGy.cm for the 0–2 years age group; 31 mGy and 508 mGy.cm for the >2–5 years group, and 32 mGy and 563 mGy.cm for the >5–10 years group, respectively. The mean DLP for 0–2 year-olds was the only parameter outside the range of corresponding published reference data. Stratification into narrower age groupings showed an increase in DLP values with age. Conclusion: An institutional review of the head CT scanning technique for emergency studies performed on children less than 2 years of age is recommended. The current study highlights the role of LDRLs in establishing institutional dosimetry baselines, in refining local imaging practice, and in enhancing patient safety. Standard age stratification for DRL and LDRL reporting is recommended.

Establishing local diagnostic reference levels for adult computed tomography in Morocco

2022 ◽  
Author(s):  
M. El Mansouri ◽  
M. Talbi ◽  
A. Choukri ◽  
O. Nhila ◽  
M. Aabid
Keyword(s):  
Computed Tomography ◽  
Adult Patients ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Head Ct ◽  
Ct Examination ◽  
Japanese Studies ◽  
The Uk

In Morocco, the radiation doses received by adult patients are increasing due to the number of CT examinations performed and the larger number of computed tomography (CT) scanners installed. The aim of this study was to evaluate the radiation doses received by patients for the most common adult CT examinations in order to establish local diagnostic reference levels (DRLs). Data from 1016 adult patients were collected during 3 months from four Moroccan hospitals. Dose length product (DLP) and volumetric computed tomography dose index (CTDIvol) were evaluated by determining the 75th percentile as diagnostic reference levels for the most common examinations including head, chest and abdomen. The DRL for each examination was compared with other studies. The established DRLs in Morocco in terms of CTDIvol were 57.4, 12.3 and 10.9 for CT examinations of the head, chest, abdomen, respectively. For DLP, they were 1020, 632 and 714, respectively. These established DRLs for CTDIvol were almost similar to the UK DRLs at all examinations, higher than the Egyptian DRLs and lower than the Japanese DRLs at the head CT examination, lower than the DRLs from Egypt and Japan at the CT abdomen examination. In terms of DLP, the DRLs were higher than those of the British studies, lower than those of the Egyptian and Japanese studies at the head CT examination were higher at chest CT and lower at abdominal CT than those of all selected studies. The higher level of established DRLs in our study demonstrates the requirement of an optimization process while keeping a good image quality for a reliable diagnosis.

scholarly journals A strategy to optimize radiation exposure for non-contrast head CT: comparison with the Japanese diagnostic reference levels

2016 ◽  
Vol 34 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Kanako K. Kumamaru ◽  
Yosuke Kogure ◽  
Michimasa Suzuki ◽  
Masaaki Hori ◽  
Atsushi Nakanishi ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Head Ct

DIAGNOSTIC REFERENCE LEVELS FOR PAEDIATRIC HEAD COMPUTED TOMOGRAPHY IN MOROCCO: A NATIONWIDE SURVEY

2020 ◽  
Vol 191 (4) ◽  
pp. 400-408
Author(s):  
M Benmessaoud ◽  
A Dadouch ◽  
M Talbi ◽  
M Tahiri ◽  
Y El-ouardi
Keyword(s):  
Computed Tomography ◽  
Nationwide Survey ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Head Ct ◽  
Ct Dose ◽  
Starting Point ◽  
Effective Doses ◽  
Head Computed Tomography

Abstract The purpose of this study was to establish the diagnostic reference levels (DRLs) for paediatric head computed tomography (CT) in Morocco and to assess the effective doses received during head CT examinations. The data of 1007 patients were collected retrospectively from Moroccan university children’s hospitals. The sample was classified per age group:&lt;1, 1–5, 5–10 and 10–15 years. The proposed DRLs were defined as 75th percentile of the distributions, which were in terms of CT dose index of 26.98, 28.88, 34.00 and 38.20 mGy and dose length product of 461.64, 540.06, 627.20 and 705.98 mGy.cm, respectively. The effective doses estimated were 3.6, 2.9, 2 and 1.79 mSv, respectively. The DRLs reported in Morocco were compared with those of other countries, which were based on the same age grouping method, including Thailand, Switzerland, Japan and the international DRLs. Our initiative via the determination of the first Moroccan diagnostic reference levels for paediatric head CT must be a starting point to spread this investigation towards other examinations and imaging modalities.

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

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.

NATIONAL DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSES FOR 13 ADULT CT PROTOCOLS AND A PAEDIATRIC HEAD CT PROTOCOL: NATIONAL SURVEY OF KOREAN HOSPITALS

2019 ◽  
Vol 187 (2) ◽  
pp. 220-229
Author(s):  
Jung Su Kim ◽  
Sang Kyung Lee ◽  
Sun-Ki Kim ◽  
Seung-Min Yoo ◽  
Jung Min Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
National Survey ◽  
Age Group ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Head Ct ◽  
Brain Ct ◽  
Ct Protocol

Abstract To develop a second set of diagnostic reference levels (DRLs) and achievable doses (ADs) for 13 adult computed tomography (CT) protocols and a paediatric head CT protocol in Korea. A survey of 13,625 CT examinations was performed based on 13 adult CT protocols and a paediatric non-contrast brain CT protocol using 369 CT systems, with patients grouped according to age. Most CT protocols in this survey had DRLs similar to those reported in other countries. However, chest and abdomen-pelvic CT had lower DRLs than those reported in the first Korean national survey and those from other countries. Paediatric non-contrast brain CT in each age group, with the exception of the 11–15-year age group, had lower DRLs than those reported in other countries. The DRLs presented here are similar to (or lower than for some protocols) those reported in the first Korean national survey and those from other countries.

scholarly journals Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

2015 ◽  
Vol 46 (2) ◽  
pp. 280-285 ◽  
Author(s):  
Yasutaka Takei ◽  
Osamu Miyazaki ◽  
Kosuke Matsubara ◽  
Yoshiya Shimada ◽  
Yoshihisa Muramatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Nationwide Survey ◽  
Diagnostic Reference Levels ◽  
Reference Levels

Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt

2017 ◽  
Vol 39 ◽  
pp. 16-24 ◽  
Author(s):  
Dina Husseiny Salama ◽  
Jenia Vassileva ◽  
Gamal Mahdaly ◽  
Mona Shawki ◽  
Ahmad Salama ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Reference Levels ◽  
Reference Levels

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

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