Abstract
BackgroundDiagnostic reference levels (DRLs) are a crucial element of auditing radiation doses in paediatric computed tomography (CT). Currently, there are no national paediatric CT DRLs in South Africa.ObjectivesThe aim of this article was to establish local paediatric DRLs for CT examinations at two academic hospitals and to compare paediatric CT radiation output levels with established DRLs in the developed and developing world.MethodComputed Tomography Dose Indexvolume (CTDIvol) and dose length product (DLP) values were collected from CT examinations performed at two university hospitals for patients aged 0–15 years, during 01 November 2016–30 April 2017. The 75th percentile of the data distribution was calculated for each CT examination type and age group, further categorised into routine working hours and after-hours for both hospitals and statistically compared.ResultsOf the 1031 CT examinations performed, CT brain examination was the most common (755/1031; 72.23%). DLP values were increased in the after-hours categories compared to regular working hours at both hospitals. The largest increase was in the 0–1 year age group (150.56%). With the exception of CT Chest and CT abdomen in the 0–1 year age group, the CTDIvol and DLP values compared favourably to international standards.ConclusionMost of the calculated DRLs are acceptable and internationally comparable. This likely indicates effective reduction techniques and protocols. Computed tomography body examination protocols for 0–1 year patients should be reviewed. Strategies should be implemented to limit higher doses in after-hours examinations.
Highlights
Since its advent in 1971, computed tomography (CT) has added tremendous value for diagnosis and establishing treatment plans for patients
European guidelines suggest the usage of the Computed Tomography Dose Indexvolume (CTDIvol) and dose length product (DLP) as CT dose descriptors.[10]
Computed Tomography Dose Indexw divided by the pitch equals CTDIvol, which is expressed in the international system of units (SI units) as milligray
Summary
Since its advent in 1971, computed tomography (CT) has added tremendous value for diagnosis and establishing treatment plans for patients. There has been an exponential increase in the usage of CT.[1] This increase is because of several factors, including, but not limited to, rapid evolvement of technology and advancements in hardware and software, which led to improved image quality and reduced duration for CT examinations.[2,3] In addition, the geopolitical and socioeconomic trends since the late 1990s contributed to greater access to medical resources and equipment, in the industrialised world.[4] The number of CT scanners per million people in Japan increased from 14.36 in 1980 to 107.14 in 2017 This increase has been the most significant in the developed world; an increase in the amount of CT scanners was observable in the developing world, for example, in Turkey, where the number of CT scanners increased from 4.89 per million people in 2002 to 14.53 per million people in 2016.4 The advances in availability and increase in applications made CT investigations popular in the paediatric patient population. There are no national paediatric CT DRLs in South Africa
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