Diagnostic reference levels in pediatric radiology in Austria
- 480 Downloads
Because of the higher sensitivity to radiation in children, optimization plays an essential role in pediatric radiology. Diagnostic reference levels are a helpful tool to optimize patient dose for standard radiographic procedures.
A nationwide survey was conducted to determine doses and variation in average dose applied to children for standard X-ray examinations. Dose values for chest, skull and abdomen X-ray procedures were determined for newborns, 1, 5, 10 and 15 year olds.
Third quartiles of patient doses are provided and compared to European, British and German reference values. Variation in average doses between hospitals (i.e., ratio of maximal to minimal applied average dose) for the same age and examination was found to be typically a factor of eight. Ratios of maximal to minimal applied doses to individual patients were found to be approximately a factor of six higher than variations of average doses between clinics.
While average patient doses indicate the use of good radiological practice in general, variance in average doses applied by different hospitals indicate that audit of dose with respect to reference values will provide guidance for optimization. Such practice should result in lowering doses for pediatric examinations.
KeywordsPediatric radiology Diagnostic reference levels Radiation protection Patient dose DRL
The authors wish to express their gratitude to all clinical partner hospitals that supplied the data on which this work is based, to Mr. Antti Kosunen and Ms. Katja Nieminen from the Finnish radiation and nuclear safety authority (STUK) for assistance and calibration of the reference KAP meter, and to Mr. Manfred Ditto from the Austrian Federal Ministry of Health, Family and Youth for helpful discussions. The project was founded by the Austrian Federal Ministry of Health, Family and Youth.
- 1.International Commission on Radiological Protection (1991) 1990 recommendations of the International Commission on Radiological Protection. ICRP publication no. 60, Annals of ICRP, 21. Pergamon, OxfordGoogle Scholar
- 2.International Commission on Radiological Protection (1996) Radiological protection and safety in medicine. ICRP publication no 73. Annals of ICRP, 26. Pergamon, OxfordGoogle Scholar
- 7.Hart D, Wall BF, Shrimpton PC, Dance DR (2000) The establishment of reference doses in paediatric radiology as a function of patient size. Rad Prot Dosim 90:235–238Google Scholar
- 9.Hart D, Wall BF, Shrimpton PC, Bungay DR, Dance DR (2000) NRPB- R318-Reference doses and patient size in paediatric radiology. NRPB-R318, NRPB, ChiltonGoogle Scholar
- 10.IAEA (International Atomic Energy Agency) (2008) Dosimetry in diagnostic radiology: an international code of practice. IAEA, ViennaGoogle Scholar
- 14.Kohn MM (1996) European guidelines on quality criteria for diagnostic radiographic images in paediatrics. Report EUR 16261. Office for Official Publications of the European Communities, LuxembourgGoogle Scholar
- 15.Bundesamt für Strahlenschutz (2003) Bekanntmachung der diagnostischen Referenzwerte für radiologische und nuklearmedizinische Untersuchungen. Bundesanzeiger 143:17503–17504Google Scholar
- 16.Bakawski C, Stein E, Kohn M, Kellner M, Schweighofer K, Cartagena G, Padovani R, Panzer W, Scheurer C, Schneider K, Fendel H, Wall B (1992) Results of a dosimetry study in the European community on frequent x-ray examination in infants. Rad Prot Dosim 43:31–36Google Scholar
- 17.Endemann B, Ernst G, Panzer W, Padovani R, Schneider K, Kohn MM, Wall B (1995) Variation in radiation dose and image quality of common x-rays of the 5-year-old child. A European wide survey in children’s clinics. Eur Radiol Suppl 5:192Google Scholar