Neige M Y Journy1,2, Serge Dreuil3, Nathalie Boddaert4,5, Jean-François Chateil6, Didier Defez7, Hubert Ducou-le-Pointe8, Jean-Marc Garcier9, Joël Guersen10, Bouchra Habib Geryes11, Andreas Jahnen12, Choonsik Lee13, Jacqueline Payen-de-la-Garanderie14, Jean-Pierre Pracros14, Dominique Sirinelli15, Isabelle Thierry-Chef16, Marie-Odile Bernier17. 1. Laboratoire d'épidémiologie des rayonnements ionisants, Unité Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France. njourny@netcourrier.fr. 2. Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9760, USA. njourny@netcourrier.fr. 3. Unité d'expertise en radioprotection médicale, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France. 4. Service de radiologie pédiatrique, INSERM U1000, UMR 1163, Institut Imagine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker Enfants Malades, 149 rue de Sèvres, 75743, Paris Cedex 15, France. 5. PRES Sorbonne Paris, Cité Université René Descartes, 190 avenue de France, 75013, Paris, France. 6. Service de radiologie et d'imagerie anténatale, de l'enfant et de la femme, Groupe Hospitalier Pellegrin, Centre Hospitalier Universitaire de Bordeaux, place Amélie Raba-Léon, 33000, Bordeaux, France. 7. Service de Physique Médicale, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Benite, France. 8. Service de Radiologie, Hôpital d'Enfants Armand-Trousseau, 26 avenue du Dr A. Netter, 75012, Paris, France. 9. Service de radiologie, Centre Hospitalier Universitaire Estaing, 1 place Lucie-Aubrac, 63003, Clermont-Ferrand Cedex 1, France. 10. Pôle Imagerie et Radiologie Interventionnelle, Centre Hospitalier Universitaire Gabriel Montpied, 58 rue Montalembert, 63003, Clermont Ferrand cedex 1, France. 11. Direction des affaires médicales, de la qualité et la relation avec les usagers, Hôpital Universitaire Necker Enfants Malades, 149 rue de Sèvres, 75743, Paris Cedex 15, France. 12. Luxembourg Institute of Science and Technology (LIST), 5 avenue des Hauts-Fourneaux, L-4362, Esch/Alzette, Luxembourg, Luxembourg. 13. Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9760, USA. 14. Service d'imagerie pédiatrique, Hôpital Femme Mère Enfants, Groupe Hospitalier Est, 59 Boulevard Pinel, 69500, Bron, France. 15. Service de radiologie pediatrique, Hôpital Clocheville, Centre Hospitalier Régional Universitaire de Tours, 49 boulevard Béranger, 37000, Tours, France. 16. Section of Environment and Cancer, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon cedex 08, France. 17. Laboratoire d'épidémiologie des rayonnements ionisants, Unité Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France.
Abstract
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).
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).
Authors: Keith J Strauss; Marilyn J Goske; Alexander J Towbin; Debapriya Sengupta; Michael J Callahan; Kassa Darge; Daniel J Podberesky; Donald P Frush; Charles Maxfield; Sjirk J Westra; Jeffrey S Prince; Huimin Wu; Mythreyi Bhargavan-Chatfield Journal: Radiology Date: 2017-02-17 Impact factor: 11.105
Authors: J Vassileva; M Rehani; D Kostova-Lefterova; H M Al-Naemi; J S Al Suwaidi; D Arandjic; E H O Bashier; S Kodlulovich Renha; L El-Nachef; J G Aguilar; V Gershan; E Gershkevitsh; E Gruppetta; A Hustuc; A Jauhari; Mohammad Hassan Kharita; N Khelassi-Toutaoui; H R Khosravi; H Khoury; I Kralik; S Mahere; J Mazuoliene; P Mora; W Muhogora; P Muthuvelu; D Nikodemova; L Novak; A Pallewatte; D Pekarovič; M Shaaban; E Shelly; K Stepanyan; N Thelsy; P Visrutaratna; A Zaman Journal: Radiat Prot Dosimetry Date: 2015-04-01 Impact factor: 0.972
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Authors: N Journy; T Roué; E Cardis; H Ducou Le Pointe; H Brisse; J-F Chateil; D Laurier; M-O Bernier Journal: J Radiol Prot Date: 2016-02-15 Impact factor: 1.394
Authors: Marilyn J Goske; Keith J Strauss; Laura P Coombs; Keith E Mandel; Alexander J Towbin; David B Larson; Michael J Callahan; Kassa Darge; Daniel J Podberesky; Donald P Frush; Sjirk J Westra; Jeffrey S Prince Journal: Radiology Date: 2013-03-19 Impact factor: 11.105
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
Authors: Choonsik Lee; Neige Journy; Brian E Moroz; Mark Little; Richard Harbron; Kieran McHugh; Mark Pearce; Amy Berrington de Gonzalez Journal: Radiat Prot Dosimetry Date: 2019-07-01 Impact factor: 0.972
Authors: Nanae Tsuchiya; Edwin Jr van Beek; Yoshiharu Ohno; Hiroto Hatabu; Hans-Ulrich Kauczor; Andrew Swift; Jens Vogel-Claussen; Jürgen Biederer; James Wild; Mark O Wielpütz; Mark L Schiebler Journal: World J Radiol Date: 2018-06-28