European Radiology

, Volume 23, Issue 3, pp 623–631 | Cite as

IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols

  • Jenia Vassileva
  • Madan M. RehaniEmail author
  • Kimberly Applegate
  • Nada A. Ahmed
  • Humoud Al-Dhuhli
  • Huda M. Al-Naemi
Computed Tomography



To survey procedures and protocols in paediatric computed tomography (CT) in 40 less resourced countries.


Under a project of the International Atomic Energy Agency, 146 CT facilities in 40 countries of Africa, Asia, Europe and Latin America responded to an electronic survey of CT technology, exposure parameters, CT protocols and doses.


Modern MDCT systems are available in 77 % of the facilities surveyed with dedicated paediatric CT protocols available in 94 %. However, protocols for some age groups were unavailable in around 50 % of the facilities surveyed. Indication-based protocols were used in 57 % of facilities. Estimates of radiation dose using CTDI or DLP from standard CT protocols demonstrated wide variation up to a factor of 100. CTDIvol values for the head and chest were between two and five times those for an adult at some sites. Sedation and use of shielding were frequently reported; immobilisation was not. Records of exposure factors were kept at 49 % of sites.


There is significant potential for improvement in CT practice and protocol use for children in less resourced countries. Dose estimates for young children varied widely. This survey provides critical baseline data for ongoing quality improvement efforts by the IAEA.

Key Points

Paediatric computed tomography (CT) practice was audited in 40 less resourced countries.

This audit revealed widespread (up to 100 times) variation in radiation dose.

Specific CT protocols for certain age groups were frequently (ca. 50 %) unavailable.

This survey demonstrates significant potential for improvement in paediatric CT practice.

Multinational networking is an effective mechanism for quality improvement.


Computed tomography Paediatric CT Patient doses Radiation protection, CT protocols 



The work was undertaken as part of technical cooperation projects of the International Atomic Energy Agency. The authors wish to thank their respective governments for their nomination to participate in the study and acknowledge the contribution of members of the team for their cooperation and understanding, in particular: Zoran Trajkovski, Jasminka Joseva, N. Naman, C. Kalambo, A. Pilly, Shady Khazzam, Julius Ziliukas, Edis Ciuksys, Inga Cibulskaite, Hashim Al Awadhi, Noirin M. Neligan, Jacek Janaczek, Fatima Al Kaabi, Wadha M. Al-Shamsi, Mohammad Abu Srour, Alfan S. Al Ameri, Sara Booz, Juan Manuel Herrera Moya, Dean Pekarovič, Ethen Jamnik, Dimitrij Kuhelj, Andrias Hambardzumyan, Marianna Harutunyan, Lusine Hakobyan, Fredy J. Gomez, Leila Sadri, Marianna Frik-Amelin, Shaid Kamal, Dr. Muzafar, Samia Saadi, Fouzia Meddad, Ahmed Merad, Rima Dib, Ali Rahanjam, Mohd Ahmed Elhallag, Laila Musabeh Mohad Almuhairi, Suresh Kamath, Tatan Saefuddin, Kukuh Nurcahyo, Damayanti Sekarsari, Olivera Ciraj-Bjelac, Djordje Lazarevic, Marcos Ely de Andrade, Nada Hassan, Einas Hamed, Ali Abdelrazeg and Alejandro Nader.

Co-authors in alphabetical order*

Jamila Salem Al Suwaidi (UAE), Danijela Arandjic (Serbia), Adnan Beganovic (Bosnia&Herzegovina), Tony Benavente (Peru), Tadeusz Bieganski (Poland), Simone Dias (Brazil), Leila El-Nachef (Lebanon), Dario Faj (Croatia), Mirtha E. Gamarra-Sánchez (Paraguay), Juan Garcia Aguilar (Mexico), Vesna Gershan (Former Yugoslav Republic of Macedonia), Eduard Gershkevitsh (Estonia), Edward Gruppetta (Malta), Alexandru Hustuc (Republic of Moldova), Sonja Ivanovic (Montenegro), Arif Jauhari (Indonesia), Mohammad Hassan Kharita (Syria), Siarhei Kharuzhyk (Belarus), Nadia Khelassi-Toutaoui (Algeria), Hamid Reza Khosravi (Iran), Desislava Kostova-Lefterova (Bulgaria), Ivana Kralik (Croatia), Lantao Liu (China), Jolanta Mazuoliene (Lithuania), Patricia Mora (Costa Rica), Wilbroad Muhogora (Tanzania), Pirunthavany Muthuvelu (Malaysia), Denisa Nikodemova (Slovakia), Leos Novak (Czech Republic), Aruna S. Pallewatte (Sri Lanka), Mohamed Shaaban (Kuwait), Esti Shelly (Israel), Karapet Stepanyan (Armenia), Eu-Leong Harvey J. Teo (Singapore), Naw Thelsy (Myanmar), Pannee Visrutaratna (Thailand), Areesha Zaman (Pakistan), Dejan Zontar (Slovenia)

*Except first author, the coordinator of the study (placed as second author), and a consultant (at third place), all other authors’ names have been arranged alphabetically by their family name. Only one principal contributor from each participating team in a country region has been included as an author, although many members were involved in the study.

Supplementary material

330_2012_2639_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 20.1 kb)


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Jenia Vassileva
    • 1
  • Madan M. Rehani
    • 2
    Email author
  • Kimberly Applegate
    • 3
  • Nada A. Ahmed
    • 4
  • Humoud Al-Dhuhli
    • 5
  • Huda M. Al-Naemi
    • 6
  1. 1.National Centre of Radiobiology and Radiation ProtectionSofiaBulgaria
  2. 2.International Atomic Energy AgencyViennaAustria
  3. 3.Emory RadiologyAtlantaUSA
  4. 4.Sudan Atomic Energy CommissionKhartoumSudan
  5. 5.Sultan Qaboos UniversityAl KhodOman
  6. 6.Hamad Medical Corp. Hamad General HospitalDohaQatar

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