TY - JOUR
T1 - Size-appropriate radiation doses in pediatric body CT
T2 - A study of regional community adoption in the United States
AU - Hopkins, Katharine L.
AU - Pettersson, David R.
AU - Koudelka, Caroline W.
AU - Spinning, Kristopher
AU - Vajtai, Petra L.
AU - Beckett, Brooke R.
AU - Bardo, Dianna M.E.
PY - 2013/9
Y1 - 2013/9
N2 - Background: During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. Objective: This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. Materials and methods: We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI vol). SSDE was calculated and differences among groups were compared by regression analysis. Results: Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Conclusions: Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged.
AB - Background: During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. Objective: This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. Materials and methods: We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI vol). SSDE was calculated and differences among groups were compared by regression analysis. Results: Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Conclusions: Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged.
KW - Children's hospitals
KW - Community hospitals
KW - Computed tomography
KW - Pediatrics
KW - Radiation dose reduction
UR - http://www.scopus.com/inward/record.url?scp=84882915556&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84882915556&partnerID=8YFLogxK
U2 - 10.1007/s00247-013-2680-7
DO - 10.1007/s00247-013-2680-7
M3 - Article
C2 - 23558461
AN - SCOPUS:84882915556
SN - 0301-0449
VL - 43
SP - 1128
EP - 1135
JO - Pediatric Radiology
JF - Pediatric Radiology
IS - 9
ER -