UniSA Allied Health and Human Performance Unit, University of South Australia, GPO Box 2471, City East Campus, SA, 5001, Adelaide, Australia.
South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Pediatr Radiol. 2022 Jun;52(7):1296-1305. doi: 10.1007/s00247-022-05290-1. Epub 2022 Mar 14.
Diagnostic reference levels (DRLs) identify unusually high patient radiation exposures and are required for dose optimisation. DRLs for pediatric fluoroscopic examinations are not widely determined in Australia.
Our objectives were to establish DRLs for pediatric fluoroscopic examinations in a South Australian tertiary hospital and compare these to previously published data and to explore relationships between patient dose area product (DAP), age and fluoroscopy times.
Dose data from 365 pediatric patients undergoing 5 fluoroscopic examinations were retrospectively collected for a 3-year period commencing January 2018 to develop local DRLs. Relationships between DAP, age and fluoroscopy time were explored using scatterplots, Spearman's correlation, and regression analyses.
Local DRLs were significantly lower than data published previously, possibly reflecting technological and procedural advancements. Each 1-year increase in patient age was associated with a 0.77 μGy·m increase in DAP for barium meal and follow-through studies (95% confidence interval [CI]=0.055, 1.48) (P=0.04), and a 1.37 μGy·m increase in DAP for barium swallow studies (95% CI=0.61, 2.12) (P<0.001). A low correlation was demonstrated between DAP and fluoroscopy time for micturating cystourethrography studies (r=0.35, 95% CI=0.15, 0.51, P<0.001) and barium meal and follow-through studies (r=0.37, 95% CI= -0.011, 0.65, P=0.05). Age and fluoroscopy time were not significantly related.
This study provides updated Australian pediatric fluoroscopic DRLs, with the intention of promoting a national database for benchmarking pediatric doses. The local DRLs can be used for dose comparisons and optimisation between facilities.
诊断参考水平（DRL）可识别出患者的辐射暴露量异常高的情况，是剂量优化所必需的。在澳大利亚，尚未广泛确定儿科透视检查的 DRL。
我们的目的是在南澳大利亚的一家三级医院建立儿科透视检查的 DRL，并将其与之前发表的数据进行比较，并探讨患者剂量面积乘积（DAP）、年龄和透视时间之间的关系。
回顾性收集了 2018 年 1 月至 2021 年 1 月期间 365 名接受 5 次透视检查的儿科患者的剂量数据，以制定本地 DRL。使用散点图、Spearman 相关和回归分析探讨 DAP、年龄和透视时间之间的关系。
本地 DRL 明显低于之前发表的数据，这可能反映了技术和程序的进步。患者年龄每增加 1 岁，钡餐和透视研究的 DAP 增加 0.77 μGy·m（95%置信区间[CI]：0.055，1.48）（P=0.04），钡吞咽研究的 DAP 增加 1.37 μGy·m（95% CI：0.61，2.12）（P<0.001）。透视时间与排泄性膀胱尿道造影研究（r=0.35，95% CI=0.15，0.51，P<0.001）和钡餐和透视研究（r=0.37，95% CI= -0.011，0.65，P=0.05）之间的相关性较低。年龄和透视时间之间没有显著关系。
本研究提供了更新的澳大利亚儿科透视 DRL，旨在促进全国儿科剂量基准数据库的建立。本地 DRL 可用于设施之间的剂量比较和优化。
