Dana Jackson RT, Presenter: Nothing to Disclose

Michael Ronald Ditchfield MBBS, Abstract Co-Author: Nothing to Disclose

Jane Grimm BS, Abstract Co-Author: Nothing to Disclose

Jennifer Clark RN, Abstract Co-Author: Nothing to Disclose

Francessa L. Wilson MBChB, Abstract Co-Author: Nothing to Disclose

Ella Onikul MD, Abstract Co-Author: Nothing to Disclose

John Kieran Pereira MBBS, Abstract Co-Author: Nothing to Disclose

Rebecca Linke, Abstract Co-Author: Nothing to Disclose

Gillian Long, Abstract Co-Author: Nothing to Disclose

Fiona Bettenay, Abstract Co-Author: Nothing to Disclose

Mark Anthony Phillips MBBCh,FRCR, Abstract Co-Author: Nothing to Disclose

Aishwariya Rajan, Abstract Co-Author: Nothing to Disclose

Shane Handley, Abstract Co-Author: Nothing to Disclose

Stacy Kellan Goergen MBBS, Abstract Co-Author: Nothing to Disclose

To measure radiation doses delivered during CT scanning by specialist pediatric hospitals in Australia and New Zealand To calculate size specific dose estimates (SSDEs)  for these examinations

8 pediatric specialist hospitals in Australia and New Zealand and 1 private practice staffed by pediatric radiologists contributed data for consecutive examinations between September 2011 and March 2012.  Individual patient scan data (including kVp, mAs, noise default settings, use of iterative reconstruction and dose modulation) and scanner generated dose metrics (CTDIvol, DLP) as well as patient girth were audited. The exam types audited were: brain (trauma), brain (shunt study), petrous temporal bone for hearing loss, paranasal sinuses, chest (mass), HRCT chest (airways disease), abdomen portal venous phase (tumour evaluation), Scanning platforms audited were: GE Discovery 750HD and VCT XT; Philips Brilliance 64 and Ingenuity 128; Siemens Somatom Definition Flash 128, Somatom Emotion 16 and Sensation 64; Toshiba Aquilion 1, Aquilion 64 and Prime. SSDE (size specific dose estimates) were calculated for each examination. Patient age in completed months was recorded for each subject and data aggregated into 4 age cohorts for comparative purposes: 0—1 year, 1-5, 5-10, 10-16.  

Although 5-10 fold variation in dose in each age cohort for a given examination were recorded, median doses for brain, chest and abdominal scans were below medians reported by a Swiss national audit of paediatric CT practice (Verdun, 2008)  and below third quartile values recommended by a Belgian audit (Buls,2010), with the exception of brain CT for trauma in the youngest two age cohorts. In these groups, median DLP and CTDIvol were 319 and 26.5 (0-1) and 459 and 31.1 (1-5), respectively. This is potentially important due to nearly half of audited CT studies in the 0-5 age group being performed for this indication.

This is the first published dataset of pediatric CT dose providing SSDEs for a  range of exams. Although median doses are generally within acceptable limits relative to other published data, variation in dose for a given age group and exam type which may be clinically unjustified indicates the need for more standardization of practice.

The publication of SSDEs for a large dataset of pediatric examinations from specialist pediatric practices will facilitate benchmarking by others.

Jackson, D, Ditchfield, M, Grimm, J, Clark, J, Wilson, F, Onikul, E, Pereira, J, Linke, R, Long, G, Bettenay, F, Phillips, M, Rajan, A, Handley, S, Goergen, S, Pediatric CT Dose Audit: A Multicenter Audit of Subspecialty Practice in Australia and New Zealand.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029254.html