Top

Published in:

01-02-2016 | Original Article

Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

Authors: Yasutaka Takei, Osamu Miyazaki, Kosuke Matsubara, Yoshiya Shimada, Yoshihisa Muramatsu, Keiichi Akahane, Keisuke Fujii, Shoichi Suzuki, Kichiro Koshida

Published in: Pediatric Radiology | Issue 2/2016

Abstract

Background

Diagnostic reference levels (DRLs) have not been established in Japan.

Objective

To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups.

Materials and methods

We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years.

Results

For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI_vol 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose–length products (DLP 16 [mGy・cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively.

Conclusion

The majority of CTDI_vol 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan.

Hashimoto S, Ugawa S, Nanko K et al (2012) The total amounts of radioactively contaminated materials in forests in Fukushima, Japan. Sci Rep 2:416CrossRefPubMedCentralPubMed

Ueda S, Hasegawa H, Kakiuchi H et al (2013) Fluvial discharges of radiocaesium from watersheds contaminated by the Fukushima Dai-ichi Nuclear Power Plant accident, Japan. J Environ Radioact 118:96–104CrossRefPubMed

International Commission on Radiological Protection (1996) Radiological protection and safety in medicine. ICRP Publication 73. Annals of ICRP(26). Pergamon Press, Oxford

Thomas KE, Wang B (2008) Age-specific effective doses for pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 38:645–656CrossRefPubMed

McNitt-Gray MF (2002) AAPM/RSNA physics tutorial for residents: topics in CT. Radiation dose in CT. Radiographics 22:1541–1553CrossRefPubMed

Shrimpton PC, Hillier MC, Lewis MA et al (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980CrossRefPubMed

Galanski M, Nagel HD, Stamm G (2006) Paediatric CT exposure practice in the Federal Republic of Germany: results of a nation-wide survey in 2005/2006. Medizinishe Hochshule, Hannover

Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18:1980–1986CrossRefPubMed

Kritsaneepaiboon S, Trinavarat P, Visrutaratna P (2012) Survey of pediatric MDCT radiation dose from university hospitals in Thailand: a preliminary for national dose survey. Acta Radiol 53:820–826CrossRefPubMed

10.

Vassileva J, Rehani MM, Applegate K et al (2013) IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol 23:623–631CrossRefPubMed

11.

Brisse HJ, Aubert B (2009) CT exposure from pediatric MDCT: results from the 2007-2008 SFIPP/ISRN survey. J Radiol 90:207–215CrossRefPubMed

12.

Nievelstein RA, van Dam IM, van der Molen AJ (2010) Multidetector CT in children: current concepts and dose reduction strategies. Pediatr Radiol 40:1324–1344CrossRefPubMedCentralPubMed

13.

Nishizawa K, Matsumoto M, Iwai K et al (2004) Survey of CT practice in Japan and collective effective dose estimation. Nippon Igaku Hoshasen Gakkai Zasshi 64:151–158PubMed

14.

Miyazaki O, Kitamura M, Masaki H et al (2005) Current practice of pediatric MDCT in Japan: survey results of demographics and age-based dose reduction. Nippon Igaku Hoshasen Gakkai Zasshi 65:216–223PubMed

15.

Fukushima Y, Tsushima Y, Takei H et al (2012) Diagnostic reference level of computed tomography (CT) in Japan. Radiat Prot Dosimetry 151:51–57CrossRefPubMed

16.

Takei Y, Suzuki S, Miyazaki O et al (2014) Summary of the survey on radiation exposure of pediatric CT examination in Japan — focus on environments of CT examination. Nippon Hoshasen Gijutsu Gakkai Zasshi 70:562–568CrossRef

17.

Paolicchi F, Faggioni L, Bastiani L et al (2014) Optimization the balance between radiation dose and image quality in pediatric head CT: findings before and after intensive radiologic staff training. AJR Am J Roentgenol 202:1309–1315CrossRefPubMed

18.

Shih G, Lu ZF, Zabih R et al (2011) Automated framework for digital radiation dose index reporting from CT dose reports. AJR Am J Roentgenol 197:1170–1174CrossRefPubMed

19.

Morin RL, Coombs LP, Chatfield MB (2011) ACR dose index registry. J Am Coll Radiol 8:288–291CrossRefPubMed

Title: Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan
Authors: Yasutaka Takei
Osamu Miyazaki
Kosuke Matsubara
Yoshiya Shimada
Yoshihisa Muramatsu
Keiichi Akahane
Keisuke Fujii
Shoichi Suzuki
Kichiro Koshida
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 2/2016
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-015-3474-x

At a glance: The STEP trials

Springer Medicine

Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2016

Standardization of patellofemoral morphology in the pediatric knee

Radiographic signs of non-venous placement of intended central venous catheters in children

Hermes

Guidelines for scanning twins and triplets with US and MRI

Diagnostic accuracy of point-of-care ultrasound for catheter-related thrombosis in children

Comparison of image quality and radiation dose between an image-intensifier system and a newer-generation flat-panel detector system — technical phantom measurements and evaluation of clinical imaging in children