Preliminary Age-Stratified Effective Dose for Pediatric Chest Radiography Using the American College of Radiology Dose Index Registry Data
Abstract
Purpose
Diagnostic medical physicists are often tasked with estimating effective dose (ED) for patient imaging procedures. As chest radiography is frequently performed in children, it is useful to know the general magnitudes of ED for various pediatric ages. The purpose of this study was to conduct a preliminary evaluation of ED magnitudes for common anatomical views of the chest for six age groups using dose index statistics from the American College of Radiology Dose Index Registry (ACR-DIR).
Methods
From the ACR-DIR participant portal, median KAP values for the 2023–2025 period were exported for six age groups (0-1yr, 1-5yr, 5-10yr, 10-15yr, 15-18yr, adult) and three chest views: anteroposterior (AP), posteroanterior (PA) and lateral (LAT). Age-stratified KAP-to-ED conversion coefficients were obtained from Publications NRPB-R279 and NRPB-R262 for pediatric and adult patients, respectively. To apply these coefficients, typical tube potential (kVp) and total filtration were needed for each age group and view. Because national kVp statistics are not yet available, typical values at our institution for a representative radiographic system were used. Measured half-value layers were used to derive the appropriate total filtrations used in the calculations.
Results
For adult patients, ED was estimated to be 0.045, 0.023, and 0.073 mSv for AP, PA, and LAT views, respectively. The latter two values are consistent with previous literature. However, the highest ED values were found in teenage-age patients: 0.056 mSv (15-18 yr), 0.033 mSv (10-15 yr), and 0.0735 mSv (10-15 yr) for AP, PA, and LAT views, respectively. Infants (0-1yr) were found to have higher ED than older children (1-5 yr and 5-10 yr).
Conclusion
Contrary to common knowledge, this preliminary analysis showed that a pediatric patient may receive a higher ED compared to an adult patient in chest radiography, suggesting the need for systematic technique optimization for the pediatric population.