Benjamin Wildman-Tobriner MD, Presenter: Nothing to Disclose

Mythreyi Chatfield PhD, Abstract Co-Author: Nothing to Disclose

Ernest Schorr Behnke MD, Abstract Co-Author: Nothing to Disclose

Donald P. Frush MD, Abstract Co-Author: Nothing to Disclose

As there is no generic information on broad demographics and contemporary dose estimates for pediatric CT, including gender and age, our aim was to investigate this using the ACR CT Dose Index Registry (DIR) as a resource.

DIR data for 30 months (7/11-12/13) were extracted for 3 common CT scans: head without contrast (head), chest with contrast (chest), abdomen/pelvis with contrast (AP) by age (>0-<3, 3-<7, 7-<11, 11-<15, 15-18). Dose parameters of CTDIvol (16 cm head, 32 cm body), dose-length product, and size-specific dose estimate (SSDE, mGy) were determined. Gender, geographic and practice (e.g., community, pediatric specialized), and entry into DIR data were gathered.

Of 2,729,170 head, chest, and AP scans for all ages, 6% (161,864) of studies were in children: 8% of head, 5% of AP, and 2% of chest scans. 72% of AP, 63% of chest, and 56% of brain scans were performed on patients 11-18 years old, and the 15-18 group had the highest frequency (35% head, 43% chest, 48% AP) for all exams. Head CT represented the highest number of scans for all ages. There was a greater frequency of exams in males (54-61%) for all age groups and scan types, except for AP in 11-<15 (48%) and 15-18 (39%). Mean SSDE ranged from 8.8-19.0 for AP and 6.0-19.8 for chest scans, increasing with each age group. The AP SSDE was higher than the chest SSDE for every age group except for the 15-18 group. SSDE was higher than CTDIvol for body CT at all ages. Pediatric contributions to the DIR increased 353% from 2011 to 2012, and 65% from 2012 to 2013. Of note, 52% of scans were from community hospitals, 29% from children’s hospitals, and 18% from academic programs.

Participation in the DIR provides an opportunity to validate trends and to set benchmarks for pediatric CT dose estimations. For example, based on SSDE, there are currently adjustments in scanning based on age and body region, and more frequent scanning occurs in teenage years. Such data can be a gauge of past impact and a guide for future efforts in dose management.

The ACR CT Dose Index Registry is a valuable resource for assessment of pediatric CT demographics and dose estimations.

Wildman-Tobriner, B, Chatfield, M, Behnke, E, Frush, D, ACR Dose Index Registry: A Resource for Pediatric CT Practice Assessment and Radiation Dose Estimations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013160.html