Bos Denise, Wang Yifei, Stewart Carly, Chu Philip W, Luong Jason, Haubold Johannes, Schröer Benjamin, Zensen Sebastian, Duong Phuong-Anh T, Schindera Sebastian, Jeukens Cécile R L P N, Das Marco, Einstein Andrew J, Cervantes Luisa, Smith-Bindman Rebecca
Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Eur Radiol. 2025 Jun 14. doi: 10.1007/s00330-025-11724-9.
Computed tomography (CT) radiation doses vary depending on medical indications, protocols, and local practice. Our aim is to establish diagnostic reference levels (DRLs) for CT categories based on clinical indications in pediatric patients.
We analyzed CT data from an international dose registry retrospectively, including scans performed in children under 18 years at 143 facilities between January 2016 and January 2021. DRLs were calculated for volumetric CT dose index (CTDI), dose-length product (DLP), and size-specific dose estimate (SSDE) across 14 CT categories, which reflect both the anatomic areas and radiation dose levels (low, routine, high dose) required by imaging indications within the anatomic areas. We compared the routine dose categories for head, chest, and abdomen/pelvis scans between facilities in the United States (U.S.) and Europe.
A total of 95,047 CT scans (mean age, 10.4 ± 5.6 years, 54% male), including 41 different indications, were included. DRLs increased with increasing age group (p < 0.05 for trend). For the head and the abdomen/pelvis body regions, there was greater variation between the CT categories than between the indications within the categories, suggesting these categories are valid. For example, in 10- to 15-year-old children, the DRLs for the DLP increased from 362 mGy·cm for head low dose to 2058 mGy·cm for head high dose. The U.S. DRLs were similar to the European for head categories, but were around twice as high for routine dose chest, and abdomen/pelvis.
We have established DRLs for indication-based CT category age groups to help standardize practice.
Question CT categories are needed to reflect body regions and clinical indications with similar radiation dose requirements in pediatric patients. Findings Doses varied more between CT categories than within. DRLs for chest and abdomen/pelvis were about twice as high in the U.S. as in Europe. Clinical relevance DRLs as a function of patient age were developed for 14 broad anatomy- and indication-based CT categories in children using registry data.
计算机断层扫描（CT）的辐射剂量因医学指征、扫描方案和当地实际操作而异。我们的目的是根据儿科患者的临床指征确定CT类别的诊断参考水平（DRL）。
我们回顾性分析了一个国际剂量登记处的CT数据，包括2016年1月至2021年1月期间在143家机构对18岁以下儿童进行的扫描。计算了14种CT类别的容积CT剂量指数（CTDI）、剂量长度乘积（DLP）和尺寸特异性剂量估计（SSDE）的DRL，这些类别既反映了解剖区域，也反映了解剖区域内成像指征所需的辐射剂量水平（低剂量、常规剂量、高剂量）。我们比较了美国和欧洲各机构头部、胸部和腹部/骨盆扫描的常规剂量类别。
共纳入95047例CT扫描（平均年龄10.4±5.6岁，54%为男性），包括41种不同的指征。DRL随年龄组增加而升高（趋势p<0.05）。对于头部和腹部/骨盆身体区域，CT类别之间的差异大于类别内指征之间的差异，表明这些类别是有效的。例如，在10至15岁儿童中，DLP的DRL从头部低剂量的362 mGy·cm增加到头部高剂量的2058 mGy·cm。美国头部类别的DRL与欧洲相似，但常规剂量胸部和腹部/骨盆的DRL约为欧洲的两倍。
我们已为基于指征的CT类别年龄组建立了DRL，以帮助规范操作。
问题 需要CT类别来反映儿科患者中具有相似辐射剂量要求的身体区域和临床指征。发现 CT类别之间的剂量差异大于类别内的差异。美国胸部和腹部/骨盆的DRL约为欧洲的两倍。临床意义 利用登记数据为儿童14种基于广泛解剖学和指征的CT类别制定了作为患者年龄函数的DRL。
