Radiation dose reduction for chest radiography of infants in intensive care units using a high peak kilovoltage-technique.

Abstract

Chest radiography is an important tool in the care of infants in intensive care units. Image optimization must be monitored to minimize radiation exposure in this susceptible population. To examine the use of a high tube peak kilovoltage technique to achieve radiation dose reduction while maintaining adequate image quality. A retrospective study was conducted. Radiation doses of chest radiographs performed in the pediatric intensive care units in our institution were calculated. The radiographs were divided into two groups based on the value of the peak kilovoltage used: above and below 60 kilovolts (kV). Image quality was blindly assessed by two fellowship-trained pediatric radiologists. Air kerma, effective dose and quality score for the high versus the low peak kilovoltage group were compared and analyzed. The study included 376 radiographs. One hundred and seven radiographs were performed using peak kilovoltage values equal to or above 60kV and 269 radiographs were performed using values under 60kV. The average air kerma for the lower peak kilovoltage group was 56.6 microgray (µGy) (30.7-81.9) vs. 22.9µGy (11.8-34.4) for the higher peak kilovoltage group (P<0.0001). The mean difference in effective dose between the groups was 11.68 (P<0.0001). The mean difference for the quality score was 0.06 (±0.03, P=0.10), not statistically significant. A high peak kilovoltage technique may enable a statistically significant radiation dose reduction without compromising the diagnostic value of the image.