Timo De Bondt1, Tom Mulkens2, Federica Zanca3,4, Lotte Pyfferoen5, Jan W Casselman5, Paul M Parizel6. 1. Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650, Antwerp, Belgium. timo.debondt@gmail.com. 2. Department of Radiology, H. Hart Hospital, Mechelsestraat 24, 2500, Lier, Belgium. 3. GE Healthcare, DoseWatch, Rue de la Minière, Buc, 78530, France. 4. KU Leuven, Imaging and Pathology Department, Herestraat 49, Leuven, 3000, Belgium. 5. Department of Radiology, AZ St. Jan Brugge-Oostende AV Hospital, Ruddershove 10, 8000, Brugge, Belgium. 6. Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650, Antwerp, Belgium.
Abstract
OBJECTIVES: To benchmark regional standard practice for paediatric cranial CT-procedures in terms of radiation dose and acquisition parameters. METHODS: Paediatric cranial CT-data were retrospectively collected during a 1-year period, in 3 different hospitals of the same country. A dose tracking system was used to automatically gather information. Dose (CTDI and DLP), scan length, amount of retakes and demographic data were stratified by age and clinical indication; appropriate use of child-specific protocols was assessed. RESULTS: In total, 296 paediatric cranial CT-procedures were collected. Although the median dose of each hospital was below national and international diagnostic reference level (DRL) for all age categories, statistically significant (p-value < 0.001) dose differences among hospitals were observed. The hospital with lowest dose levels showed smallest dose variability and used age-stratified protocols for standardizing paediatric head exams. Erroneous selection of adult protocols for children still occurred, mostly in the oldest age-group. CONCLUSION: Even though all hospitals complied with national and international DRLs, dose tracking and benchmarking showed that further dose optimization and standardization is possible by using age-stratified protocols for paediatric cranial CT. Moreover, having a dose tracking system revealed that adult protocols are still applied for paediatric CT, a practice that must be avoided. KEY POINTS: • Significant differences were observed in the delivered dose between age-groups and hospitals. • Using age-adapted scanning protocols gives a nearly linear dose increase. • Sharing dose-data can be a trigger for hospitals to reduce dose levels.
OBJECTIVES: To benchmark regional standard practice for paediatric cranial CT-procedures in terms of radiation dose and acquisition parameters. METHODS: Paediatric cranial CT-data were retrospectively collected during a 1-year period, in 3 different hospitals of the same country. A dose tracking system was used to automatically gather information. Dose (CTDI and DLP), scan length, amount of retakes and demographic data were stratified by age and clinical indication; appropriate use of child-specific protocols was assessed. RESULTS: In total, 296 paediatric cranial CT-procedures were collected. Although the median dose of each hospital was below national and international diagnostic reference level (DRL) for all age categories, statistically significant (p-value < 0.001) dose differences among hospitals were observed. The hospital with lowest dose levels showed smallest dose variability and used age-stratified protocols for standardizing paediatric head exams. Erroneous selection of adult protocols for children still occurred, mostly in the oldest age-group. CONCLUSION: Even though all hospitals complied with national and international DRLs, dose tracking and benchmarking showed that further dose optimization and standardization is possible by using age-stratified protocols for paediatric cranial CT. Moreover, having a dose tracking system revealed that adult protocols are still applied for paediatric CT, a practice that must be avoided. KEY POINTS: • Significant differences were observed in the delivered dose between age-groups and hospitals. • Using age-adapted scanning protocols gives a nearly linear dose increase. • Sharing dose-data can be a trigger for hospitals to reduce dose levels.
Authors: Kalpana M Kanal; Janessa M Graves; Monica S Vavilala; Kimberly E Applegate; Jeffrey G Jarvik; Frederick P Rivara Journal: AJR Am J Roentgenol Date: 2015-03 Impact factor: 3.959
Authors: Janessa M Graves; Kalpana M Kanal; Frederick P Rivara; Jeffrey G Jarvik; Monica S Vavilala Journal: J Am Coll Radiol Date: 2013-12-20 Impact factor: 5.532
Authors: John D Mathews; Anna V Forsythe; Zoe Brady; Martin W Butler; Stacy K Goergen; Graham B Byrnes; Graham G Giles; Anthony B Wallace; Philip R Anderson; Tenniel A Guiver; Paul McGale; Timothy M Cain; James G Dowty; Adrian C Bickerstaffe; Sarah C Darby Journal: BMJ Date: 2013-05-21