Christopher Smith MD, Presenter: Nothing to Disclose

Kathy McKay, Abstract Co-Author: Nothing to Disclose

Benvon C. Cramer MBBCh, Abstract Co-Author: Nothing to Disclose

Digital radiography (DR) has been widely adopted because of its workflow benefits and has also been marketed as having a benefit in terms of dose reduction. The purpose of this study is to determine the estimated radiation dosages to patients associated with pediatric radiographs, comparing computed and digital radiographic systems.

This is a retrospective and prospective case series of pediatric radiographs performed over a period of two years during a renovation from a CR to a DR digital system. Parameters measured were kVp, mAs and patient weight, sex and age. Estimates of dose were derived from published pediatric conversion factors.

The mean estimated doses associated with a sample of (n=2515) pediatric chest and sinus radiographs taken using CR vs DR systems were .18 vs .09 and .16 vs .07 mSv, respectively (p <.01). On average, the dose imparted by digital radiography is 50% that of computed radiography. There is considerable variability in the dose imparted by pediatric radiographs (SD = .07-8 mSv), with the type of imaging system accounting for 22% and 26% of the variability in chest and sinus radiographs, respectively, in regression models.

"Plain film" radiography accounts for the majority of pediatric imaging and there has been a considerable increase in pediatric radiographic volume performed in North America over the past decade. Monitoring and optimization of radiation dose in the pediatric setting is therefore essential. Adoption of DR systems is one way this can be achieved. The type of digital system only explains part of the overall dose variability. Although it was not systematically assessed in this study, a review of dose outliers suggests technique is also an important contributor to dose variability. This study provides important information towards meeting the ALARA principle in the pediatric setting where the risks associated with radiation dose are the greatest.

Radiographic doses are non-trivial and variable across pediatric patients imaged at a single institution. Dose reduction can be achieved is through the adoption of direct digital radiographic systems

Smith, C, McKay, K, Cramer, B, Estimated Radiation Exposure from Routine Pediatric Radiographs Comparing Computed and Direct Digital Radiography.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044409.html