Ago Jacob Leonard, Inkoom Stephen, Ohene-Botwe Benard, Larsen Alise, Berg Ingerd Skaaret
Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu Campus, Korle-Bu, P. O. Box KB 143, Accra, Ghana.
Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, College of Basic and Applied Sciences, University of Ghana, Atomic Campus, Accra, Ghana.
BMC Med Imaging. 2025 Apr 17;25(1):125. doi: 10.1186/s12880-025-01675-4.
Whole-body computed tomography (WBCT) technique involves higher radiation doses, resulting in increased stochastic health risks, especially when used for paediatric patients. Hence, protocol optimisation is recommended to maximise its benefit-risk ratio, with several available strategies to achieve it. This study used the figure-of-merit (FOM) approach to develop optimised protocols for paediatric WBCT examinations. The rationale is to enhance diagnostic accuracy while minimising radiation exposure, ultimately improving patient safety and outcomes for paediatric patients undergoing WBCT.
Newborn and child (5-year-old) anthropomorphic phantoms were scanned with different scan protocols and evaluated for dose and image quality using the CT-Expo and ImageJ programs, respectively. The protocols for trunk examinations were divided into arterialphase-only and combined arterial and venous phase to develop appropriate protocols based on patients' initial focused assessment with sonography for trauma (FAST) results. The protocols with the highest FOMs were selected as the best optimised protocols.
The estimated WBCT ED (WB) for the optimised protocols ranged from 2.6 mSv to 5.8 mSv with estimated FOM of 3.83 to 59.35. The mean effective doses (EDs) for newborn and child arterial phase-only protocols were not significantly lower than the combined arterial and venous phase protocols (p = 0.069, 0.082 respectively), while the mean signal-to-noise ratio of the combined phase protocols for newborn and child phantoms were insignificantly higher than the single-phase protocol (p = 0.089, 0.662 respectively).
The estimated ED from this study were lower than established values. The selected protocols are recommended for newborns and children (1-7 years) using the GE Revolution CT and Siemens SOMATOM Definition Edge CT scanners.
全身计算机断层扫描（WBCT）技术涉及较高的辐射剂量，会增加随机健康风险，尤其是用于儿科患者时。因此，建议进行方案优化以最大化其效益风险比，有多种可用策略来实现这一目标。本研究采用品质因数（FOM）方法为儿科WBCT检查制定优化方案。其基本原理是在将辐射暴露降至最低的同时提高诊断准确性，最终改善接受WBCT检查的儿科患者的安全性和预后。
使用不同的扫描方案对新生儿和儿童（5岁）仿真人体模型进行扫描，并分别使用CT-Expo和ImageJ程序评估剂量和图像质量。将躯干检查方案分为仅动脉期和动脉期与静脉期联合，根据患者的初始创伤超声重点评估（FAST）结果制定合适的方案。选择具有最高FOM的方案作为最佳优化方案。
优化方案的估计WBCT有效剂量（WB）范围为2.6 mSv至5.8 mSv，估计FOM为3.83至59.35。新生儿和儿童仅动脉期方案的平均有效剂量并不显著低于动脉期与静脉期联合方案（分别为p = 0.069、0.082），而新生儿和儿童仿真人体模型联合期方案的平均信噪比略高于单相方案（分别为p = 0.089、0.662）。
本研究估计的有效剂量低于既定值。推荐使用GE Revolution CT和西门子SOMATOM Definition Edge CT扫描仪对新生儿和1 - 7岁儿童采用所选方案。
