PMID- 34698569
OWN - NLM
STAT- MEDLINE
DCOM- 20220110
LR  - 20220110
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 302
IP  - 1
DP  - 2022 Jan
TI  - U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT 
      Examinations.
PG  - 164-174
LID - 10.1148/radiol.2021211241 [doi]
AB  - Background Diagnostic reference levels (DRLs) and achievable doses (ADs) were 
      developed for the 10 most commonly performed pediatric CT examinations in the 
      United States using the American College of Radiology Dose Index Registry. 
      Purpose To develop robust, current, national DRLs and ADs for the 10 most 
      commonly performed pediatric CT examinations as a function of patient age and 
      size. Materials and Methods Data on 10 pediatric (ie, patients aged 18 years and 
      younger) CT examinations performed between 2016 and 2020 at 1625 facilities were 
      analyzed. For head and neck examinations, dose indexes were analyzed based on 
      patient age; for body examinations, dose indexes were analyzed for patient age 
      and effective diameter. Data from 1 543 535 examinations provided medians for AD 
      and 75th percentiles for DRLs for volume CT dose index (CTDI(vol)), dose-length 
      product (DLP), and size-specific dose estimate (SSDE). Results Of all facilities 
      analyzed, 66% of the facilities (1068 of 1625) were community hospitals, 16% (264 
      of 1625) were freestanding centers, 9.5% (154 of 1625) were academic facilities, 
      and 3.5% (57 of 1625) were dedicated children's hospitals. Fifty-two percent of 
      the patients (798 577 of 1 543 535) were boys, and 48% (744 958 of 1 543 535) 
      were girls. The median age of patients was 14 years (boys, 13 years; girls, 15 
      years). The head was the most frequent anatomy examined with CT (876 655 of 
      1 543 535 examinations [57%]). For head without contrast material CT 
      examinations, the age-based CTDI(vol) AD ranged from 19 to 46 mGy, and DRL ranged 
      from 23 to 55 mGy, with both AD and DRL increasing with age. For body 
      examinations, DRLs and ADs for size-based CTDI(vol), SSDE, and DLP increased 
      consistently with the patient's effective diameter. Conclusion Diagnostic 
      reference levels and achievable doses as a function of patient age and effective 
      diameter were developed for the 10 most commonly performed CT pediatric 
      examinations using American College of Radiology Dose Index Registry data. These 
      benchmarks can guide CT facilities in adjusting pediatric CT protocols and 
      resultant doses for their patients. (c) RSNA, 2021 An earlier incorrect version 
      appeared online. This article was corrected on October 29, 2021.
FAU - Kanal, Kalpana M
AU  - Kanal KM
AUID- ORCID: 0000-0002-2089-5230
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Butler, Priscilla F
AU  - Butler PF
AUID- ORCID: 0000-0001-8406-392X
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Chatfield, Mythreyi B
AU  - Chatfield MB
AUID- ORCID: 0000-0001-7734-925X
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Wells, Jered
AU  - Wells J
AUID- ORCID: 0000-0002-9953-5050
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Samei, Ehsan
AU  - Samei E
AUID- ORCID: 0000-0001-7451-3309
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Simanowith, Michael
AU  - Simanowith M
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Golden, Dan
AU  - Golden D
AUID- ORCID: 0000-0003-1894-1776
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Gress, Dustin A
AU  - Gress DA
AUID- ORCID: 0000-0003-2978-8420
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Burleson, Judy
AU  - Burleson J
AUID- ORCID: 0000-0003-0011-2742
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Sensakovic, William F
AU  - Sensakovic WF
AUID- ORCID: 0000-0002-5283-1848
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Strauss, Keith J
AU  - Strauss KJ
AUID- ORCID: 0000-0002-0087-976X
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
FAU - Frush, Donald
AU  - Frush D
AUID- ORCID: 0000-0002-6928-4465
AD  - From the Department of Radiology (K.M.K), University of Washington, 1959 NE 
      Pacific St, Box 357987, Seattle, WA 98195-7987; Department of Quality and Safety 
      (P.F.B., M.B.C., M.S., D. Golden, D. Gress, J.B.), American College of Radiology, 
      Reston, Va; Department of Radiology (J.W., E.S., D.F.), Duke University Medical 
      Center, Durham, NC; Department of Radiology (W.S.), Mayo Clinic, Phoenix, Ariz; 
      and Department of Radiology (K.S.), Cincinnati Children's Hospital Medical 
      Center, Cincinnati, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20211026
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
SB  - IM
EIN - Radiology. 2022 Jan;302(1):E6. PMID: 34928733
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - *Diagnostic Reference Levels
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Practice Guidelines as Topic
MH  - *Radiation Dosage
MH  - Registries
MH  - Tomography, X-Ray Computed/*methods/*statistics & numerical data
MH  - United States
EDAT- 2021/10/27 06:00
MHDA- 2022/01/11 06:00
CRDT- 2021/10/26 12:17
PHST- 2021/10/27 06:00 [pubmed]
PHST- 2022/01/11 06:00 [medline]
PHST- 2021/10/26 12:17 [entrez]
AID - 10.1148/radiol.2021211241 [doi]
PST - ppublish
SO  - Radiology. 2022 Jan;302(1):164-174. doi: 10.1148/radiol.2021211241. Epub 2021 Oct 
      26.