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Multicentre survey on patient dose in paediatric imaging and proposal for updated diagnostic reference levels for France. Part 1: computed tomography

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Abstract

Objectives

To report on a dose survey conducted by the French societies of radiology and paediatric imaging (SFR and SFIPP) and the French public service expert in nuclear and radiological risks (IRSN), and to suggest new diagnostic reference levels (DRLs) for paediatric CT.

Methods

Dose reports concerning children aged 0–15 years and five CT procedures (brain, petrous bone, mediastinum, lung and abdomen-pelvis) performed in 2015–2016 were collected from 15 imaging departments on a voluntary basis. Volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded for at least 10 patients per procedure, per centre and per age group. New DRLs were calculated as the 3rd quartiles of the distributions of the median values.

Results

Results from 3253 CT examinations were obtained. The exposure levels observed were much lower than for the previous surveys (2007–2008 and 2010–2013) and among the lowest values currently published. A good homogeneity between facilities was also observed. New DRLs are proposed for each procedure and age group.

Conclusions

This new survey contributes to the continuing optimisation process in French paediatric CT practice. Its results have been recently used to update the national paediatric CT DRLs.

Key Points

• New national diagnostic reference levels (DRLs) are proposed for several paediatric CT procedures.

• The DRLs proposed for brain, chest and abdomen-pelvis procedures are among the lowest published worldwide.

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Abbreviations

ATCM:

Automatic tube current modulation

COCIR:

European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry

CQV:

Coefficient of quartile variation

CT:

Computed tomography

CTDIvol :

Volume computed tomography dose index

DLP:

Dose-length product

DRL:

Diagnostic reference level

IAEA:

International Atomic Energy Agency

ICRP:

International Commission on Radiological Protection

IR:

Iterative reconstruction

IRSN:

Institut de Radioprotection et de Sûreté Nucléaire

PMMA:

Poly(methyl methacrylate)

Q 1 :

First quartile

Q 3 :

Third quartile

SFIPP:

Société Francophone d’Imagerie Pédiatrique et Prénatale

SFR:

Société Française de Radiologie

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Acknowledgements

The authors are very grateful to the staff (radiologists, medical physicists, managers and radiographers) of the imaging departments who participated in this study and who took the time to collect and check the data for plain radiography, diagnostic fluoroscopy and/or CT:

Hôpital Jean Minjoz (CHU), Besançon: Dr. M. Lenoir, B. Pigny.

Hôpital Pellegrin (CHU), Bordeaux: Pr JF. Chateil, M. Eresue-Bony.

Hôpital Femme mère Enfant (HCL), Bron: Dr. J. Payen de la Garanderie, P. Tylski.

Hôpital Couple Enfant (CHU), Grenoble: Dr. C. Durand, G. Reboulet.

Hôpital Bicêtre (AP-HP), Le Kremlin-Bicêtre: Pr C. Adamsbaum, Dr. B. Husson.

Hôpital de la Timone (AP-HM), Marseille: Pr Ph. Petit, Dr. B. Bourlière Najean, E. Bigand.

SELARL Imagerie médicale du Truc, Mérignac: Dr. M. Brun.

Hôpital Arnaud de Villeneuve (CHU), Montpellier: Dr. O. Prod’homme, Dr. I. Taleb Arrada, J. Le Roy.

SELARL Imagerie du Val, Limours: Dr. I. Ivert.

Hôpital d’Enfants Armand-Trousseau (AP-HP), Paris: Pr H. Ducou Le Pointe, A. Hornbeck.

Hôpital Necker (AP-HP), Paris: Pr N. Boddaert, B. Habib Geryes.

Hôpital Robert Debré (AP-HP), Paris: Pr M. Alison, C. Guegan.

Institut Curie, Paris: Dr. H. Brisse, N. Pierrat, S. Lasalle.

Hôpital Pontchaillou (CHU), Rennes: Dr. C. Treguier, G. Briand.

Hôpital Charles Nicolle (CHU), Rouen: Pr JN. Dacher, O. Lucas, N. Izambard.

Hôpital Hautepierre (CHU), Strasbourg: Dr. M. Koob, N. Wallior.

Hôpital Clocheville (CHU), Tours: Pr D. Sirinelli, MC. Dousteyssier, C. Fertault Coquet.

Hôpital d’Enfants Brabois (CHU), Vandoeuvre-lès-Nancy: Dr. L. Mainard-Simard.

Funding

The authors state that this work has not received any funding.

Author information

Correspondence to David Célier.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Hervé J. Brisse.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this study was a survey on patient doses to assess diagnostic reference levels, carried out in accordance with DRLs national regulations and international guidance.

Ethical approval

Institutional Review Board approval was not required because this study was a survey on patient doses to assess diagnostic reference levels, carried out in accordance with DRLs national regulations and international guidance.

Methodology

• Prospective

• Multicentre study

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Célier, D., Roch, P., Etard, C. et al. Multicentre survey on patient dose in paediatric imaging and proposal for updated diagnostic reference levels for France. Part 1: computed tomography. Eur Radiol 30, 1156–1165 (2020). https://doi.org/10.1007/s00330-019-06405-3

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Keywords

  • Multidetector computed tomography
  • Paediatrics
  • Radiation exposure
  • Radiation protection