Abstract
Background
Diagnostic reference levels (DRLs) have not been established in Japan.
Objective
To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups.
Materials and methods
We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years.
Results
For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDIvol 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose–length products (DLP 16 [mGy・cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively.
Conclusion
The majority of CTDIvol 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hashimoto S, Ugawa S, Nanko K et al (2012) The total amounts of radioactively contaminated materials in forests in Fukushima, Japan. Sci Rep 2:416
Ueda S, Hasegawa H, Kakiuchi H et al (2013) Fluvial discharges of radiocaesium from watersheds contaminated by the Fukushima Dai-ichi Nuclear Power Plant accident, Japan. J Environ Radioact 118:96–104
International Commission on Radiological Protection (1996) Radiological protection and safety in medicine. ICRP Publication 73. Annals of ICRP(26). Pergamon Press, Oxford
Thomas KE, Wang B (2008) Age-specific effective doses for pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 38:645–656
McNitt-Gray MF (2002) AAPM/RSNA physics tutorial for residents: topics in CT. Radiation dose in CT. Radiographics 22:1541–1553
Shrimpton PC, Hillier MC, Lewis MA et al (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980
Galanski M, Nagel HD, Stamm G (2006) Paediatric CT exposure practice in the Federal Republic of Germany: results of a nation-wide survey in 2005/2006. Medizinishe Hochshule, Hannover
Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18:1980–1986
Kritsaneepaiboon S, Trinavarat P, Visrutaratna P (2012) Survey of pediatric MDCT radiation dose from university hospitals in Thailand: a preliminary for national dose survey. Acta Radiol 53:820–826
Vassileva J, Rehani MM, Applegate K et al (2013) IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol 23:623–631
Brisse HJ, Aubert B (2009) CT exposure from pediatric MDCT: results from the 2007-2008 SFIPP/ISRN survey. J Radiol 90:207–215
Nievelstein RA, van Dam IM, van der Molen AJ (2010) Multidetector CT in children: current concepts and dose reduction strategies. Pediatr Radiol 40:1324–1344
Nishizawa K, Matsumoto M, Iwai K et al (2004) Survey of CT practice in Japan and collective effective dose estimation. Nippon Igaku Hoshasen Gakkai Zasshi 64:151–158
Miyazaki O, Kitamura M, Masaki H et al (2005) Current practice of pediatric MDCT in Japan: survey results of demographics and age-based dose reduction. Nippon Igaku Hoshasen Gakkai Zasshi 65:216–223
Fukushima Y, Tsushima Y, Takei H et al (2012) Diagnostic reference level of computed tomography (CT) in Japan. Radiat Prot Dosimetry 151:51–57
Takei Y, Suzuki S, Miyazaki O et al (2014) Summary of the survey on radiation exposure of pediatric CT examination in Japan — focus on environments of CT examination. Nippon Hoshasen Gijutsu Gakkai Zasshi 70:562–568
Paolicchi F, Faggioni L, Bastiani L et al (2014) Optimization the balance between radiation dose and image quality in pediatric head CT: findings before and after intensive radiologic staff training. AJR Am J Roentgenol 202:1309–1315
Shih G, Lu ZF, Zabih R et al (2011) Automated framework for digital radiation dose index reporting from CT dose reports. AJR Am J Roentgenol 197:1170–1174
Morin RL, Coombs LP, Chatfield MB (2011) ACR dose index registry. J Am Coll Radiol 8:288–291
Acknowledgments
We thank the members of Japanese Society of Radiological Technology for their cooperation in the questionnaire survey, and Mr. Yuta Matsunaga and Ms. Ai Kawaguchi for their assistance in sending and collecting the questionnaire. This research was financially supported by the Japanese Society of Radiological Technology (Scientific Research Group 2012 grant) and a Japanese National Center for Child Health and Development (grant 26–20).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Rights and permissions
About this article
Cite this article
Takei, Y., Miyazaki, O., Matsubara, K. et al. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan. Pediatr Radiol 46, 280–285 (2016). https://doi.org/10.1007/s00247-015-3474-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-015-3474-x