Establishment of diagnostic reference level for computed tomography of head pediatrics in Morocco: A pilot study

Abstract

Pediatric patients are well documented to be at higher risk of developing radiation-induced cancer than the average adult. This pilot study aims to estimate the radiation doses to pediatric patients during head Computed Tomography (CT), in order to establish local Diagnostic Reference Level (DRL).Data from 300 pediatric head CT examinations from 6 public hospitals were analyzed. The age group concerned is 5–10 years. The CT facilities were 64, 16, 4 and dual slice type. CT data included scanner acquisition parameters, the number of series, use of the contrast medium, rotation time, slice thickness, as well as the displayed CT Dose Index (CTDIvol) and the Dose Length Product (DLP). The effective dose and DRL were evaluated using the formalism and conversion factor of the International Commission on Radiological Protection (ICRP).The overall mean CT dose per procedure from different facilities was 44,97 mGy, 883,67 mGy.cm and 2,81 mSv for CTDIvol, DLP and effective dose, respectively. The mean third quartile dose per head CT procedure from all facilities was 40,94 mGy and 969,90 mGy.cm cm for CTDI and DLP, in that order. These results proved that pediatric patients are exposed to unnecessary doses of radiation during CT examination in public healthcare institution of Morocco.The DRL obtained was slightly higher than those established in some countries. Pediatric radiation dose per procedure indicated a wide variation between various hospitals and even in the same hospital for different patients. This pilot study showed the need for practices unification and radiation doses optimization during CT scan acquisition for pediatric patients in radiology departments.