Image Quality Analysis, Effective Dose and Radiogenic Risks Pediatric Patients Undergoing Contrast-Enhanced Computed Tomography Procedures
Abstract
Purpose
The purpose of this study is to evaluate image quality, effective dose, and projected cancer risk to patients during pediatric Contrast-Enhanced Computed Tomography (CECT) procedures.
Methods
This study was conducted at three hospitals equipped with CT scanners from various manufacturers (160, 64, and 16 slice). Image quality was assessed subjectively by 2 radiologists (3 ≤10 years of experience). In total, 300 procedures were obtained, and Cvol was corrected using the Size-Specific Dose Estimate (SSDE). The effective dose was estimated using CT-Expo Software.
Results
The overall mean values for CTDIvol (mGy) and DLP (mGy.cm) in pediatric patients were 7.1±3 and 1230 ±680 for Cvol (mGy) and PKL (mGy.cm), respectively. The average effective dose is 25 mSv, resulting in one excess cancer per 2,000 pediatric CT abdomen, with girls have 30% higher risk.
Conclusion
The pediatric dose is higher than in most previous studies. While the patient doses per CECT procedure showed a wide variation in Cvol (mGy), up to 3-fold, a larger variation was observed in the complete CECT abdomen procedure, up to 10-fold. The variation was attributed to scan length, number of phases, protocol settings, clinical indication, and use of dose-saving software. While advanced CT technology is equipped with dose-saving abilities, children receive unnecessary exposure, resulting in avoidable cancer risks.