Results and analysis of examination doses for paediatric CT procedures based on a nationwide survey in China

• Published in: European radiology Vol. 34; no. 3; pp. 1659 - 1666
• Main Authors: Xu, Hui, Sun, Quan-Fu, Yue, Bao-Rong, Cheng, Jin-sheng, Niu, Yan-tao
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2024; Springer Nature B.V
• Subjects: Abdomen; Adolescent; Age; Age groups; Chest; Child; Children; China - epidemiology; Computed Tomography; Diagnostic Radiology; Hospitals; Humans; Imaging; Internal Medicine; Interventional Radiology; Medical imaging; Medicine; Medicine & Public Health; Neuroradiology; Patients; Pediatrics; Radiation Dosage; Radiology; Reference Values; Scanners; Scanning; Surveys; Thorax; Tomography, X-Ray Computed - methods; Ultrasound; China; Surveys and questionnaires; Diagnostic reference levels; Radiation protection; Radiation dosage; Multidetector computed tomography
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-023-10005-7

Objective To report the results of a dose survey conducted across 31 provinces in mainland China from 2017 to 2018 and to analyse the dose level to determine the national diagnostic reference levels (DRLs) for paediatric CT procedures. Methods At least ten patients for each age group (0– < 1, 1– < 5, 5– < 10, 10– < 15 years) and each procedure (head, chest and abdomen) for each CT scanner were selected from four to eight hospitals in each province. The dose information (CTDI vol and DLP) was collected from the HIS or RIS-PACS systems. The median values in each CT scanner were considered the representative dose values for the paediatric patients in CT scanning. The national DRLs were estimated based on the 75th percentile distribution of the median values. Results A total of 24,395 patients and 319 CT scanners were investigated across 262 hospitals. For paediatric CT scanning in 4 different age groups, the median ( P 50 ) and the 75th percentile ( P 75 ) of CTDI vol and DLP for each scanning procedure were calculated and reported. National DRLs were then proposed for each procedure and age group. Conclusion The dose level of CT scanning for children in mainland China was reported for the first time. The DRLs for paediatric CT in the present study are similar to those in some Asian countries but higher than those in European countries. Clinical relevance statement The paediatric CT is an extensively used tool in diagnosing paediatric disease; however, children are more sensitive to radiation. Establishing the diagnostic reference level of paediatric CT examination is necessary to reduce the dose of CT in children and promote the optimisation of medical exposure. Key Points • The DRLs for 3 paediatric CT procedures (head, chest and abdomen) and 4 age groups (0– < 1, 1– < 5, 5– < 10, 10– < 15 years) were proposed in mainland China first time. • The examination parameter and dose for children need to be further optimised in China, especially to lower the tube voltage in paediatric CT.