Diagnostic reference level (DRL) analysis of CT scan modality for head procedure on pediatric patient

Abstract

Diagnostic Reference Level (DRL) is an effective tool recommended by the International Atomic Energy Agency (IAEA) to improve medical exposure optimization, especially for Diagnostic and Interventional Radiology. In Indonesia, the establishment of DRL for pediatric patients has not done yet. This study aims to analyze the DRL for CT Scan modality on the head procedure for pediatric patients. Pediatric patient dose data were collected from hospitals that reported the data into a web-based application called Patient Dose Data Information System (Si-INTAN). Analysis of DRL was based on 75 percentile (Q3) analysis of patient dose distribution in certain age groups. Q3 analysis was done as a separator between acceptable dose and exceeds doses. The exceed doses need to be evaluated. The analysis was done for the volume-Computed Tomography Dose Index (CTDIvol) and Dose-Length Product (DLP). The result showed a correlation between patient age and CTDIvol value based on experience in Indonesia. However, for DLP quantity, the correlation between patient age and DLP can only be seen if DRL of < 1 year is excluded. The results of comparisons with DRL in adult patients indicated that DRL in 9–14 age group patients is quite high for the CTDIvol quantity (65 mGy and 65.1 mGy, respectively). DLP quantity comparison for < 1 and 9–14 age group are higher than adult patient (1468 mGy.cm, 1519 mGy.cm and 1400 mGy.cm respectively). Evaluation of examination procedure needs to be done to improve the optimization in medical exposure for the pediatric patient, and the pediatric DRL can be lower than DRL for the adult patient.