Abstract
ObjectivesTo describe first experience of integrating assessment of image quality in paediatric X-ray computed tomography (CT) with analysis of the radiation dose indices to develop reference doses called acceptable quality dose (AQD).MethodsImage quality was scored by the radiologists at a tertiary care hospital in Qatar on a scale of 0 to 4 using the recently published scoring criteria. The patients undergoing head, chest and abdomen CT were divided in different weight groups as follows: < 5 kg, 5–< 15 kg, 15–< 30 kg, 30–< 50 kg, 50–< 80 kg and > 80 kg. The images that were clinically acceptable (score of 3) were included for assessment of median values of CTDIvol and DLP to obtain AQDs in different weight groups.ResultsAfter initial training in image quality scoring of CT images of 49 patients by three radiologists, the study on 715 patients indicated 665 studies (93%) were clinically acceptable as per scoring criteria. The median CTDIvol values for the above weight groups were 16, 20, 22, 22, 27 and 27 mGy and the median DLP values for these weight groups were 271, 377, 463, 486, 568 and 570 mGy cm, respectively, for head CT. Similar values are presented for chest and abdomen CTs.ConclusionsThe first ever experience of starting with image quality assessment and integrating it with analysis of dose indices to obtain AQD values shall provide a workable model for others and values for comparison within the facility and in other facilities leading to optimisation.Key Points• The first study to integrate image quality assessment with analysis of patient dose indices shows feasibility for routine practice in other centres.• The values of acceptable quality dose (AQD) were provided for head, chest and abdomen CT of children divided into weight groups rather than age. They shall act as reference values for future studies.• Verification of our findings on proportional increase in exposure parameters (CTDIvol and DLP) with weight by other investigators shall be helpful.
Highlights
Some tissues in children are more radiosensitive than in adults and the need for higher concern in radiation protection of children has been recognised [1, 2]
The values of acceptable quality dose (AQD) were provided for head, chest and abdomen Computed tomography (CT) of children divided into weight groups rather than age
The purpose of the current study is to provide our experience with image quality assessment using the image quality scoring criteria (IQSC) and provide assessment of AQD for which data is not yet available from other sources, being a new concept
Summary
Some tissues in children are more radiosensitive than in adults and the need for higher concern in radiation protection of children has been recognised [1, 2]. While DRLs have proved to be of value for the purpose for which they were developed, that is, cutting down exposures higher than the 75th percentile of dose distribution, the limitations of DRLs in overall scheme of optimisation have increasingly been identified [11, 12]. The ugly aspects of DRLs include the following facts: First, DRLs are not applicable to individual patients. Image quality has been neglected so far when estimating DRLs. Fourth, DRLs may be occasionally perceived as a dose limit [11,12,13]. DRLs may be occasionally perceived as a dose limit [11,12,13] In view of these limitations, alternative approaches are most urgently needed
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