Muhogora W E, Ahmed N A, Alsuwaidi J S, Beganovic A, Ciraj-Bjelac O, Gershan V, Gershkevitsh E, Grupetta E, Kharita M H, Manatrakul N, Maroufi B, Milakovic M, Ohno K, Ben Omrane L, Ptacek J, Schandorf C, Shaaban M S, Toutaoui N, Sakkas D, Wambani J S, Rehani M M
Tanzania Atomic Energy Commission, PO Box 743, Arusha, Tanzania.
Radiat Prot Dosimetry. 2010 Jun;140(1):49-58. doi: 10.1093/rpd/ncq015. Epub 2010 Feb 11.
The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.
本研究的目的是调查非洲、亚洲和东欧28个发展中国家128家CT机构中15岁以下儿科患者的计算机断层扫描（CT）检查频率，并评估CT剂量大小。19个国家的101家CT机构提供了辐射剂量数据。使用标准方法，针对胸部、胸部（高分辨率）、腰椎、腹部和骨盆CT检查，根据加权CT剂量指数（CTDI(w)）、容积CT指数和剂量长度乘积（DLP）进行剂量评估。结果显示，在非洲、亚洲和东欧的参与中心，儿科CT检查的平均频率分别占所有CT检查的20%、16%和5%。发现六个国家的11家CT机构对儿科患者使用成人CT曝光参数，这表明意识有限且需要优化。CT图像质量足以用于诊断。CTDI(w)的变化范围在非洲高达55倍、在亚洲为16.3倍、在东欧为6.6倍。相应的DLP变化范围分别为10倍、20倍和8倍。总体而言，日本的CTDI(w)和DLP值低于本研究中三个地区的相应值。该研究表明，许多发展中国家更需要对儿童CT检查进行正当性论证及其优化。需要提高辐射剂量意识、开展培训并进行监测，以此作为前进的方向。
