From the Department of Radiology (K.M.K), University of Washington, 1959 NE Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Radiology. 2022 Jan;302(1):164-174. doi: 10.1148/radiol.2021211241. Epub 2021 Oct 26.
Background Diagnostic reference levels (DRLs) and achievable doses (ADs) were developed for the 10 most commonly performed pediatric CT examinations in the United States using the American College of Radiology Dose Index Registry. Purpose To develop robust, current, national DRLs and ADs for the 10 most commonly performed pediatric CT examinations as a function of patient age and size. Materials and Methods Data on 10 pediatric (ie, patients aged 18 years and younger) CT examinations performed between 2016 and 2020 at 1625 facilities were analyzed. For head and neck examinations, dose indexes were analyzed based on patient age; for body examinations, dose indexes were analyzed for patient age and effective diameter. Data from 1 543 535 examinations provided medians for AD and 75th percentiles for DRLs for volume CT dose index (CTDI), dose-length product (DLP), and size-specific dose estimate (SSDE). Results Of all facilities analyzed, 66% of the facilities (1068 of 1625) were community hospitals, 16% (264 of 1625) were freestanding centers, 9.5% (154 of 1625) were academic facilities, and 3.5% (57 of 1625) were dedicated children's hospitals. Fifty-two percent of the patients (798 577 of 1 543 535) were boys, and 48% (744 958 of 1 543 535) were girls. The median age of patients was 14 years (boys, 13 years; girls, 15 years). The head was the most frequent anatomy examined with CT (876 655 of 1 543 535 examinations [57%]). For head without contrast material CT examinations, the age-based CTDI AD ranged from 19 to 46 mGy, and DRL ranged from 23 to 55 mGy, with both AD and DRL increasing with age. For body examinations, DRLs and ADs for size-based CTDI, SSDE, and DLP increased consistently with the patient's effective diameter. Conclusion Diagnostic reference levels and achievable doses as a function of patient age and effective diameter were developed for the 10 most commonly performed CT pediatric examinations using American College of Radiology Dose Index Registry data. These benchmarks can guide CT facilities in adjusting pediatric CT protocols and resultant doses for their patients. © RSNA, 2021
背景 使用美国放射学院剂量指数注册中心的数据，为美国最常进行的 10 项儿科 CT 检查制定了诊断参考水平（DRL）和可实现剂量（AD）。目的 为 10 项最常进行的儿科 CT 检查制定基于患者年龄和体型的强大、最新的全国性 DRL 和 AD。材料与方法 分析了 2016 年至 2020 年间在 1625 个设施进行的 10 项儿科（即年龄在 18 岁及以下的患者）CT 检查的数据。对于头颈部检查，根据患者年龄分析剂量指标；对于体部检查，根据患者年龄和有效直径分析剂量指标。1543535 次检查的数据提供了容积 CT 剂量指数（CTDI）、剂量长度乘积（DLP）和体型特异性剂量估计值（SSDE）的 AD 中位数和 DRL 的 75 百分位数。结果 在分析的所有设施中，66%（1625 个中的 1068 个）为社区医院，16%（1625 个中的 264 个）为独立中心，9.5%（1625 个中的 154 个）为学术机构，3.5%（1625 个中的 57 个）为专门的儿童医院。52%（1543535 名患者中的 798577 名）为男性，48%（1543535 名患者中的 744958 名）为女性。患者的中位年龄为 14 岁（男孩 13 岁；女孩 15 岁）。头部是最常接受 CT 检查的解剖结构（1543535 次检查中的 876655 次[57%]）。对于无对比剂的头部 CT 检查，基于年龄的 CTDI AD 范围为 19 至 46 mGy，DRL 范围为 23 至 55 mGy，AD 和 DRL 均随年龄增长而增加。对于体部检查，基于体型的 CTDI、SSDE 和 DLP 的 DRL 和 AD 随着患者有效直径的增加而持续增加。结论 使用美国放射学院剂量指数注册中心的数据，为 10 项最常进行的 CT 儿科检查制定了基于患者年龄和有效直径的 DRL 和 AD。这些基准可以指导 CT 设施调整儿科 CT 协议和为患者提供的剂量。
