Reducing radiation exposure from computed tomography of the brain in children — report of a practical approach

Abstract

To reduce radiation exposure to paediatric neurosurgical patients from computed tomography (CT), a CT scanning protocol - lower radiation dose and selective scan segment (LDSS) protocol was used for CT brain at the authors' hospital. To evaluate the amount of reduction in radiation exposure by using this LDSS protocol compared to their usual protocol, the authors prospectively documented their findings. From May 2010 to June 2011, paediatric neurosurgical patients requiring CT brain, and when it was not a clinical emergency and there was baseline CT or MRI brain available, were evaluated for the LDSS protocol. The LDSS protocol used a lower tube current-time product and a shorter scan length to attain a lower total radiation dose. The CT scanning parameters of the patients' usual CT brain and LDSS CT were recorded and compared. Adverse events were also recorded. A total of 24 paediatric patients were included. Using the LDSS protocol, the effective doses were between 9% and 80% of the usual protocol and, in 20 patients, ≤50% of the usual protocol. The tube voltage was 120 kV. For patients below 10 years old, 100 mA s was adequate for the purposes of their CTs; in some patient categories, it was lower than 100 mA s. For patients aged 10 or above, 150 mA s was used. The scan length varied. Radiation exposure from CT brain in paediatric neurosurgical patients could be reduced by adopting a CT scanning protocol, which aimed dynamically at a lower tube current-time product and a shorter scan length than the usual settings at a hospital.