Radiation Dose Evaluation in Pediatric Patients Undergoing Repeated Brain Computed Tomography Examinations.

Background

Repeated brain computed tomography (CT) scans in children may result in substantial cumulative radiation exposure, particularly in young children, who are more sensitive to ionizing radiation. The purpose of the study was to assess the dose levels of radiation in patients who receive repeated brain CT during childhood and adherence rates to pediatric imaging protocols.

Methods

A retrospective cross-sectional study was conducted among 177 patients aged ≤5 years who underwent two or more brain CT examinations with a total of 514 CT examinations. The information was gathered through the hospital Picture Archiving and Communication System (PACS), which included patient demographics, scan parameters, and scanner-reported dose indicators such as volume-averaged computed tomography dose index (CTDIvol) and dose-length product (DLP). The effective dose (ED) was calculated and compared with estimated doses based on a nominal pediatric CT protocol.

Results

The findings indicated a great variation in scan parameters, with CTDIvol values of 8.9 to 51.7 mGy and DLP values of 177 to 1310 mGy.cm. The number of repeated scans showed a great increase in the cumulative ED (p < 0.001). The median doses in patients below the age of one year were greater than those in older children. There was also a closer relation of scanner-reported doses to adult protocols, which suggests a lack of an optimized pediatric setting.

Conclusions

Children under 5 who undergo repeated brain CT scans may face excessive radiation exposure. The matter is aggravated by the fact that scans are performed repeatedly without optimization of the dose, which leads to significant cumulative ED.