Individual radiation exposure from computed tomography: a survey of paediatric practice in French university hospitals, 2010–2013

• Published in: European radiology Vol. 28; no. 2; pp. 630 - 641
• Main Authors: Journy, Neige M. Y., Dreuil, Serge, Boddaert, Nathalie, Chateil, Jean-François, Defez, Didier, Ducou-le-Pointe, Hubert, Garcier, Jean-Marc, Guersen, Joël, Habib Geryes, Bouchra, Jahnen, Andreas, Lee, Choonsik, Payen-de-la-Garanderie, Jacqueline, Pracros, Jean-Pierre, Sirinelli, Dominique, Thierry-chef, Isabelle, Bernier, Marie-Odile
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2018; Springer Nature B.V; Springer Verlag
• Subjects: Abdomen; Adolescent; Age; Body parts; Chest; Child; Child, Preschool; Children; Computation; Computed tomography; Computer applications; Computer Science; Computer simulation; Data collection; Diagnostic Radiology; Diagnostic systems; Dose-Response Relationship, Radiation; Female; France; Head; Header files; Hospitals; Hospitals, University; Humans; Imaging; Infant; Infant, Newborn; Information processing; Internal Medicine; Interventional Radiology; Male; Mediastinum; Medical Imaging; Medicine; Medicine & Public Health; Neck; Neuroradiology; Paediatric; Phantoms, Imaging; Polls & surveys; Radiation; Radiation Dosage; Radiation effects; Radiation Exposure - statistics & numerical data; Radiology; Scanning; Sinus; Sinuses; Spine; Tomography, X-Ray Computed - methods; Ultrasound; Computed tomography, X-ray; Radiation protection; Radiation dosage; Paediatrics; Healthcare surveys
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-5001-y

Objectives
To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs).
Methods
The survey was conducted in radiology departments of six major university hospitals in France in 2010–2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms.
Results
CTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2–4 for most body parts, but 5–7 for abdominal examinations and 4–14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years).
Conclusion
The results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children.
Key points
 • CTDIvol varied little with age for routine head scans.
 • CTDIvol was lowest in youngest children for chest or abdominal scans.
 • Individual and inter-department variability warrant enhanced standardisation of practices.
 • Recent surveys support the need for revised diagnostic reference levels.
 • More attention should be given to specific protocols (sinuses, neck, spine, mediastinum).