nach oben

Erschienen in:

01.11.2015 | Computed Tomography

Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand

verfasst von: D. Jackson, K. Atkin, F. Bettenay, J. Clark, M. R. Ditchfield, J. E. Grimm, R. Linke, G. Long, E. Onikul, J. Pereira, M. Phillips, F. Wilson, E. Paul, S. K. Goergen

Erschienen in: European Radiology | Ausgabe 11/2015

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate paediatric CT dosimetry in Australia and New Zealand and calculate size-specific dose estimates (SSDEs) for chest and abdominal examinations.

Methods

Eight hospitals provided data from 12 CT systems for 1462 CTs in children aged 0–15. Imaging data were recorded for eight examinations: head (trauma, shunt), temporal bone, paranasal sinuses, chest (mass) and chest HRCT (high-resolution CT), and abdomen/pelvis (mass/inflammation). Dose data for cranial examinations were categorised by age and SSDEs by lateral dimension. Diagnostic reference ranges (DRRs) were defined by the 25th and 75th percentiles. Centralised image quality assessment was not undertaken.

Results

DRRs for 201 abdominopelvic SSDEs were: 2.8–4.7, 3.6–11.5, 8.5–15.0, 7.6–15, and 10.6–16.2 for the <15 cm, 15–19 cm, 20–24 cm, 25–29 cm and >30 cm groups, respectively. For 147 chest examinations using these body width categories, SSDE DRRs were 2.0–4.4, 3.3–7.9, 4.0–9.4, 4.5–12, and 6.5–12. Kilovoltage peak (kVp), but not AEC or IR, was associated with SSDE (parameter estimate [standard error]: 0.12 (0.03); p < 0.0001).

Conclusions

Australian and New Zealand paediatric CT DRRs and abdominal SSDEs are comparable to international data. SSDEs for chest examinations are proposed. Dose variations could be reduced by adjusting kVp.

Key Points

• SSDEs can be calculated for all patients, CT systems, and practices

• Kilovoltage peak (kVp) has the greatest association with dose in similar-sized patients

• Paediatric DRRs for CT are now available for use internationally

Townsend BA, Callahan MJ, Zurakowski D, Taylor GA (2010) Has pediatric CT at children's hospitals reached its peak? AJR 194(5):1194–1196CrossRefPubMed

Brady Z, Cain TM, Johnston PN (2011) Paediatric CT imaging trends in Australia. J Med Imaging Radiat Oncol 55(2):132–142CrossRefPubMed

Brenner DJ, Hall EJ (2007) Computed tomography–an increasing source of radiation exposure. N Engl J Med 357(22):2277–2284CrossRefPubMed

Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176(2):289–296CrossRefPubMed

UNSCEAR (2010) Report of the United Nations Scientific Committee on the Effects of Atomic radiation 2010. United Nations, New York

Preston DL, Kusumi S, Tomonaga M et al (1994) Cancer incidence in atomic bomb survivors. Part III. Leukemia, lymphoma and multiple myeloma, 1950–1987. Radiat Res 137(2 Suppl):S68–S97CrossRefPubMed

Land CE (1995) Studies of cancer and radiation dose among atomic bomb survivors. The example of breast cancer. JAMA 274(5):402–407CrossRefPubMed

Land CE, Saku T, Hayashi Y et al (1996) Incidence of salivary gland tumors among atomic bomb survivors, 1950–1987. Evaluation of radiation-related risk. Radiat Res 146(1):28–36CrossRefPubMed

Preston DL, Ron E, Tokuoka S et al (2007) Solid cancer incidence in atomic bomb survivors: 1958–1998. Radiat Res 168(1):1–64CrossRefPubMed

10.

Preston DL, Cullings H, Suyama A, et al. Solid cancer incidence in atomic bomb survivors exposed in utero or as young children. J Natl Cancer Inst 100(6):428–436.

11.

Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380(9840):499–505PubMedCentralCrossRefPubMed

12.

Matthews J (2013) Cancer incidence in 680,000 Australians exposed to CT scans. BMJ

13.

Donnelly LF, Frush DP (2001) Fallout from recent articles on radiation dose and pediatric CT. Pediatr Radiol 31(6):388, discussion 9–91 CrossRefPubMed

14.

The ALARA (2002) (as low as reasonably achievable) concept in pediatric CT intelligent dose reduction. Multidisciplinary conference organized by the Society of Pediatric Radiology. August 18–19, 2001. Pediatr Radiol 32(4):217–313CrossRef

15.

Boone JM, Geraghty EM, Seibert JA, Wootton-Gorges SL (2003) Dose reduction in pediatric CT: a rational approach. Radiology 228(2):352–360CrossRefPubMed

16.

Linton OW, Mettler FA Jr (2003) National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR Am J Roentgenol 181(2):321–329CrossRefPubMed

17.

Donnelly LF (2005) Reducing radiation dose associated with pediatric CT by decreasing unnecessary examinations. AJR 184(2):655–657CrossRefPubMed

18.

Goske MJ, Applegate KE, Boylan J et al (2008) The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 38(3):265–269CrossRefPubMed

19.

Strauss KJ, Goske MJ, Frush DP, Butler PF, Morrison G (2009) Image Gently Vendor Summit: working together for better estimates of pediatric radiation dose from CT. AJR 192(5):1169–1175CrossRefPubMed

20.

Strauss KJ, Goske MJ, Kaste SC et al (2010) Image gently: Ten steps you can take to optimize image quality and lower CT dose for pediatric patients. AJR 194(4):868–873CrossRefPubMed

21.

Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79(948):968–980CrossRefPubMed

22.

Galanski M, Nagel HD, Stamm G (2007) Paediatric CT Exposure Practise in the Federal Republic of Germany: Results of a nation-wide survey in 2005/06. Medizinische Hochschule, Hannover

23.

Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18(9):1980–1986CrossRefPubMed

24.

Brisse HJ, Aubert B (2009) CT exposure from pediatric MDCT: results from the 2007–2008 SFIPP/ISRN survey. J Radiol 90(2):207–215CrossRefPubMed

25.

Buls N, Bosmans H, Mommaert C, Malchair F, Clapuyt P, Everarts P (2010) CT paediatric doses in Belgium: a multi-centre study—Results from a dosimetry audit in 2007–2009. Belgian Federal Agency of Nuclear Control (FANC)

26.

Vassileva J, Rehani MM, Applegate K, Ahmed NA, Al-Dhuhli H, Al-Naemi HM (2012) IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol 23(3):623–631

27.

AAPM. Size-Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations. AAPM Report No 204. One Physics Ellipse, College Park, MD 20740-38462011

28.

Watson DJ, Coakley KS (2010) Paediatric CT reference doses based on weight and CT dosimetry phantom size: local experience using a 64-slice CT scanner. Pediatr Radiol 40(5):693–703CrossRefPubMed

29.

Goske MJ, Strauss KJ, Coombs LP, Mandel KE, Towbin AJ, Larson DB, Callahan MJ, Darge K, Podberesky DJ, Frush DP, Westra SJ, Prince JS (2013) Diagnostic reference ranges for pediatric abdominal CT. Radiology 268(1):208–218CrossRefPubMed

30.

Kambadakone AR, Prakash P, Hahn PF, Sahani DV (2010) Low-dose CT examinations in Crohn's disease: Impact on image quality, diagnostic performance, and radiation dose. AJR Am J Roentgenol 195(1):78–88CrossRefPubMed

31.

Yu L, Bruesewitz MR, Thomas KB, Fletcher JG, Kofler JM, McCollough CH (2011) Optimal tube potential for radiation dose reduction in pediatric CT: principles, clinical implementations, and pitfalls. Radiographics 31(3):835–848CrossRefPubMed

32.

Yu L, Li H, Fletcher JG, McCollough CH (2010) Automatic selection of tube potential for radiation dose reduction in CT: a general strategy. Med Phys 37:234–243CrossRefPubMed

33.

Fletcher JG. Adjusting kVP to improve image quality or reduce radiation dose. http://www.aapm.org/meetings/2011CTS/documents/Fletcher_AAPM_2011-AutokV.pd

34.

Hough DM, Fletcher JG, Grant KL, Fidler JL, Yu L, Geske JR, Carter RE, Raupach R, Schmidt B, Flohr T, McCollough CH (2012) Lowering Kilovoltage to Reduce Radiation Dose in Contrast-Enhanced Abdominal CT: Initial Assessment of a Prototype Automated Kilovoltage Selection Tool. AJR 199(5):1070–1077CrossRefPubMed

35.

Wallace A, Goergen SK, Schick D et al (2010) CT dose: clinical practice improvement strategies from a successful optimization program. J Am Coll Radiol 7:614–624CrossRefPubMed

Titel: Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand
verfasst von: D. Jackson
K. Atkin
F. Bettenay
J. Clark
M. R. Ditchfield
J. E. Grimm
R. Linke
G. Long
E. Onikul
J. Pereira
M. Phillips
F. Wilson
E. Paul
S. K. Goergen
Publikationsdatum: 01.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3727-y

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand