OPTIMIZING RADIATION EXPOSURE IN PEDIATRIC CT EXAMS
Keywords:
computed tomography, radiation exposure, optimization, tube voltageAbstract
The use of computed tomography (CT) scans in pediatric patients has raised concerns regarding radiation exposure and associated long-term health risks. This study explores the strategies and methodologies employed for optimizing radiation doses in pediatric CT examinations while ensuring diagnostic accuracy.Methods: Through a comprehensive literature review, various optimization techniques and protocols were analyzed. This involved investigating the use of lower tube voltage, iterative reconstruction algorithms, shielding, and specialized pediatric protocols. Additionally, the impact of dose-tracking systems and education on radiographers and clinicians was examined to ensure adherence to best practices.
Results: The analysis revealed that employing lower tube voltage significantly reduces radiation exposure without compromising image quality, especially in children. Iterative reconstruction algorithms demonstrated promising results in maintaining image quality while reducing doses. Tailored pediatric protocols and dose-tracking systems further contributed to minimizing radiation exposure.
Discussion: Balancing diagnostic accuracy with radiation safety is paramount in pediatric CT imaging. While advancements in technology offer promising solutions, interdisciplinary collaboration, continuous education, and strict adherence to optimized protocols are imperative to mitigate radiation risks in children undergoing CT examinations.
Conclusion: Optimizing radiation exposure in pediatric CT exams involves a multifaceted approach, integrating technological advancements, protocol enhancements, and continuous education. Implementing these strategies ensures diagnostic efficacy while prioritizing the safety of pediatric patients.
References
Abulail A, Rahman AA, Noor Azman NZ, Hassan J.; (2023); Monitoring Pediatric Head CT Scan Dose Levels: A Retrospective Study of Diagnostic Reference Levels in a Single Hospital in Abu Dhabi, UAE. Applied Sciences; 13(8):4662
Afzal, D., Khan, D.; (2023); Pediatric CT Scanning: Optimizing Image Quality and Reducing Dose
Al Mahrooqi K.M.S., Ng C.K.C., Sun Z.;(2015);Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review. J Med Imaging Radiat Sci.;46(2):241-249
Berrington de González A, Mahesh M, Kim KP, et al.;(2009); Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med;169(22):2071–2077
Bernier, M. et al.,(2018);Cohort Profile: the EPI-CT study: a European pooled epidemiological study to quantify the risk of radiation-induced cancer from paediatric CT; Int. J. Epidemiol,
Brenner D, Elliston C, Hall E, Berdon W;(2001); Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol;176(2):289–296De Bondt T, Mulkens T, Zanca F, Pyfferoen L, Casselman JW, Parizel PM.;(2017);Benchmarking pediatric cranial
CT protocols using a dose tracking software system: a multicenter study. Eur Radiol.;27(2):841-850den Harder AM, Willemink MJ, Budde RP, Schilham AM, Leiner T, de Jong PA.;(2015);Hybrid and model-based iterative reconstruction techniques for pediatric CT. AJR Am J Roentgenol.;204(3):645-53
Franck C, Smeets P, Lapeire L, Achten E, Bacher K.;(2018);Estimating the patient-specific dose to the thyroid and breasts and overall risk in chest CT when using organ-based tube current modulation. Radiology.;288(1):164–169
Kamdem, F.E., Ngano, S.O., Alla Takam, C. et al.;(2021);Optimization of pediatric CT scans in a developing country. BMC Pediatr;21, 44
Khan D, Kirby D, Bryson S, Shah M, Rahman Mohammed A.;(2022);Paediatric specific dosage forms: Patient and formulation considerations. Int J Pharm.;616:121501
Maxfield M.W., Schuster K.M., McGillicuddy E.A., Young C.J., Ghita M., Bokhari S.A., Oliva I.B., Brink J.A.,
Davis K.A.;(2012);Impact of adaptive statistical iterative reconstruction on radiation dose in evaluation of trauma patients. J Trauma Acute Care Surg.;73(6):1406-11
Miglioretti DL, Johnson E, Williams A, et al.;(2013);The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr;167(8):700–707
Nagayama Y, Oda S, Nakaura T, Tsuji A, Urata J, Furusawa M, Utsunomiya D, Funama Y, Kidoh M, Yamashita Y. (2018). Radiation Dose Reduction at Pediatric CT: Use of Low Tube Voltage and Iterative Reconstruction. Radiographics;38(5):1421-1440
Nie P., Li H., Duan Y.;(2014);Impact of sinogram affirmed iterative reconstruction (SAFIRE) algorithm on image quality with 70 kVp-tube-voltage dual-source CT angiography in children with congenital heart disease. PLoS One.;9:e91123
Noid G., Tai A., Chen G.P., Robbins J., Li X.A.;(2017);Reducing radiation dose and enhancing imaging quality of 4DCT for radiation therapy using iterative reconstruction algorithms. Adv Radiat Oncol.;2(3):515-521
Papadakis A.E., Damilakis J.;(2020);Evaluation of an organ-based tube current modulation tool in pediatric CT examinations. Eur Radiol.;30(10):5728-5737
Tubiana M, Feinendegen LE, Yang C, Kaminski JM;(2009); The linear no-threshold relationship is inconsistent with radiation biologic and experimental data. Radiology;251(1):13–22
