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Radiation dose reduction for chest radiography of infants in intensive care units using a high peak kilovoltage-technique

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Abstract

Background

Chest radiography is an important tool in the care of infants in intensive care units. Image optimization must be monitored to minimize radiation exposure in this susceptible population.

Objective

To examine the use of a high tube peak kilovoltage technique to achieve radiation dose reduction while maintaining adequate image quality.

Materials and methods

A retrospective study was conducted. Radiation doses of chest radiographs performed in the pediatric intensive care units in our institution were calculated. The radiographs were divided into two groups based on the value of the peak kilovoltage used: above and below 60 kilovolts (kV). Image quality was blindly assessed by two fellowship-trained pediatric radiologists. Air kerma, effective dose and quality score for the high versus the low peak kilovoltage group were compared and analyzed.

Results

The study included 376 radiographs. One hundred and seven radiographs were performed using peak kilovoltage values equal to or above 60 kV and 269 radiographs were performed using values under 60 kV. The average air kerma for the lower peak kilovoltage group was 56.6 microgray (µGy) (30.7–81.9) vs. 22.9 µGy (11.8–34.4) for the higher peak kilovoltage group (P<0.0001). The mean difference in effective dose between the groups was 11.68 (P<0.0001). The mean difference for the quality score was 0.06 (±0.03, P=0.10), not statistically significant.

Conclusion

A high peak kilovoltage technique may enable a statistically significant radiation dose reduction without compromising the diagnostic value of the image.

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Acknowledgements

We thank Tali Bdolah-Abram for her valuable assistance in study design and data analysis.

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Authors and Affiliations

  1. Department of Radiology, Rambam Health Care Campus, 8 Ha’aliya Ha’shniya Str, Haifa, 3525408, Israel

    Anat Yahav-Dovrat

  2. Department of Radiology, University of Manitoba, Winnipeg, Canada

    Idris Elbakri & Katya Rozovsky

  3. The Goldchleger Eye Institute, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel

    Amir Abd Elkader

  4. Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Benjamin Koplewitz

  5. The Radiology Department, Hadassah Medical Center, Jerusalem, Israel

    Benjamin Koplewitz

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  1. Anat Yahav-Dovrat
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  2. Idris Elbakri
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  3. Katya Rozovsky
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  4. Amir Abd Elkader
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  5. Benjamin Koplewitz
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Correspondence to Anat Yahav-Dovrat.

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Yahav-Dovrat, A., Elbakri, I., Rozovsky, K. et al. Radiation dose reduction for chest radiography of infants in intensive care units using a high peak kilovoltage-technique. Pediatr Radiol 52, 874–882 (2022). https://doi.org/10.1007/s00247-021-05262-x

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  • DOI: https://doi.org/10.1007/s00247-021-05262-x

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