Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) · 2026
Optimizing radiation dose and image quality in pediatric head CT: a comparison between children's and regional hospitals in the Canadian province of Nova Scotia.
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Tonkopi Elena, Ahmad Tahani, Kotlyarova Yulia, Kimber Jessica, Iwaskow Megan, Gunn Catherine
Аннотация
PURPOSE: To compare radiation doses and image quality from pediatric head CT examinations performed at a children's hospital and general regional hospitals, and to propose local diagnostic reference levels (LDRLs).
METHODS: Data were retrospectively collected from five scanners in three hospitals; only routine non-specialized examinations were included. Patients were grouped by age: <1, 1-5, 6-10, and 11-15 years. LDRLs were determined as the 75th percentile of the pooled dose indices distributions and modeled as continuous functions of patients' AP thickness and age using quantile regression. Samples of 25 studies from each scanner were randomly selected and blinded for qualitative and quantitative image quality analysis. Differences in radiation doses between scanners were assessed using the Kruskal-Wallis test. Factors potentially affecting image quality were evaluated using the Pearson correlation coefficient.
RESULTS: The dose survey included 358 studies, of which 125 were assessed for image quality. LDRLs were established as discrete quantities in each age group and modeled as an exponential-type function. Differences in dose indices between scanners were statistically significant (p-value <0.05) for all age categories. Pearson correlation coefficients demonstrated a weak correlation between radiation dose and the image quality total score across all scanners.
CONCLUSION: Significant dose variability was observed among scanners, with only a weak association between radiation dose and image quality. Examinations at a specialized pediatric facility resulted in higher radiation doses compared to general hospitals in the province. The derived LDRLs provide a useful benchmark for optimizing pediatric head CT and standardizing imaging across hospitals.
METHODS: Data were retrospectively collected from five scanners in three hospitals; only routine non-specialized examinations were included. Patients were grouped by age: <1, 1-5, 6-10, and 11-15 years. LDRLs were determined as the 75th percentile of the pooled dose indices distributions and modeled as continuous functions of patients' AP thickness and age using quantile regression. Samples of 25 studies from each scanner were randomly selected and blinded for qualitative and quantitative image quality analysis. Differences in radiation doses between scanners were assessed using the Kruskal-Wallis test. Factors potentially affecting image quality were evaluated using the Pearson correlation coefficient.
RESULTS: The dose survey included 358 studies, of which 125 were assessed for image quality. LDRLs were established as discrete quantities in each age group and modeled as an exponential-type function. Differences in dose indices between scanners were statistically significant (p-value <0.05) for all age categories. Pearson correlation coefficients demonstrated a weak correlation between radiation dose and the image quality total score across all scanners.
CONCLUSION: Significant dose variability was observed among scanners, with only a weak association between radiation dose and image quality. Examinations at a specialized pediatric facility resulted in higher radiation doses compared to general hospitals in the province. The derived LDRLs provide a useful benchmark for optimizing pediatric head CT and standardizing imaging across hospitals.