PMID- 23513245
OWN - NLM
STAT- MEDLINE
DCOM- 20130827
LR  - 20220409
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 268
IP  - 1
DP  - 2013 Jul
TI  - Diagnostic reference ranges for pediatric abdominal CT.
PG  - 208-18
LID - 10.1148/radiol.13120730 [doi]
AB  - PURPOSE: To develop diagnostic reference ranges (DRRs) and a method for an 
      individual practice to calculate site-specific reference doses for computed 
      tomographic (CT) scans of the abdomen or abdomen and pelvis in children on the 
      basis of body width (BW). MATERIALS AND METHODS: This HIPAA-compliant multicenter 
      retrospective study was approved by institutional review boards of participating 
      institutions; informed consent was waived. In 939 pediatric patients, CT doses 
      were reviewed in 499 (53%) male and 440 (47%) female patients (mean age, 10 
      years). Doses were from 954 scans obtained from September 1 to December 1, 2009, 
      through Quality Improvement Registry for CT Scans in Children within the National 
      Radiology Data Registry, American College of Radiology. Size-specific dose 
      estimate (SSDE), a dose estimate based on BW, CT dose index, dose-length product, 
      and effective dose were analyzed. BW measurement was obtained with electronic 
      calipers from the axial image at the splenic vein level after completion of the 
      CT scan. An adult-sized patient was defined as a patient with BW of 34 cm. An 
      appropriate dose range for each DRR was developed by reviewing image quality on a 
      subset of CT scans through comparison with a five-point visual reference scale 
      with increments of added simulated quantum mottle and by determining DRR to 
      establish lower and upper bounds for each range. RESULTS: For 954 scans, DRRs 
      (SSDEs) were 5.8-12.0, 7.3-12.2, 7.6-13.4, 9.8-16.4, and 13.1-19.0 mGy for BWs 
      less than 15, 15-19, 20-24, 25-29, and 30 cm or greater, respectively. The 
      fractions of adult doses, adult SSDEs, used within the consortium for patients 
      with BWs of 10, 14, 18, 22, 26, and 30 cm were 0.4, 0.5, 0.6, 0.7, 0.8, and 0.9, 
      respectively. CONCLUSION: The concept of DRRs addresses the balance between the 
      patient's risk (radiation dose) and benefit (diagnostic image quality). 
      Calculation of reference doses as a function of BW for an individual practice 
      provides a tool to help develop site-specific CT protocols that help manage 
      pediatric patient radiation doses.
FAU - Goske, Marilyn J
AU  - Goske MJ
AD  - Department of Radiology, James M. Anderson Center for Healthcare Systems 
      Excellence, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, 
      Cincinnati, OH 45229-3039, USA. marilyn.goske@cchmc.org
FAU - Strauss, Keith J
AU  - Strauss KJ
FAU - Coombs, Laura P
AU  - Coombs LP
FAU - Mandel, Keith E
AU  - Mandel KE
FAU - Towbin, Alexander J
AU  - Towbin AJ
FAU - Larson, David B
AU  - Larson DB
FAU - Callahan, Michael J
AU  - Callahan MJ
FAU - Darge, Kassa
AU  - Darge K
FAU - Podberesky, Daniel J
AU  - Podberesky DJ
FAU - Frush, Donald P
AU  - Frush DP
FAU - Westra, Sjirk J
AU  - Westra SJ
FAU - Prince, Jeffrey S
AU  - Prince JS
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130319
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adolescent
MH  - Chi-Square Distribution
MH  - Child
MH  - Child, Preschool
MH  - Contrast Media
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Radiation Dosage
MH  - Radiographic Image Interpretation, Computer-Assisted
MH  - Radiography, Abdominal/*methods
MH  - Reference Values
MH  - Registries
MH  - Retrospective Studies
MH  - *Tomography, X-Ray Computed
EDAT- 2013/03/21 06:00
MHDA- 2013/08/28 06:00
CRDT- 2013/03/21 06:00
PHST- 2013/03/21 06:00 [entrez]
PHST- 2013/03/21 06:00 [pubmed]
PHST- 2013/08/28 06:00 [medline]
AID - radiol.13120730 [pii]
AID - 10.1148/radiol.13120730 [doi]
PST - ppublish
SO  - Radiology. 2013 Jul;268(1):208-18. doi: 10.1148/radiol.13120730. Epub 2013 Mar 
      19.