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Diagnostic reference ranges for pediatric abdominal CT.

Publication ,  Journal Article
Goske, MJ; Strauss, KJ; Coombs, LP; Mandel, KE; Towbin, AJ; Larson, DB; Callahan, MJ; Darge, K; Podberesky, DJ; Frush, DP; Westra, SJ; Prince, JS
Published in: Radiology
July 2013

PURPOSE: To develop diagnostic reference ranges (DRRs) and a method for an individual practice to calculate site-specific reference doses for computed tomographic (CT) scans of the abdomen or abdomen and pelvis in children on the basis of body width (BW). MATERIALS AND METHODS: This HIPAA-compliant multicenter retrospective study was approved by institutional review boards of participating institutions; informed consent was waived. In 939 pediatric patients, CT doses were reviewed in 499 (53%) male and 440 (47%) female patients (mean age, 10 years). Doses were from 954 scans obtained from September 1 to December 1, 2009, through Quality Improvement Registry for CT Scans in Children within the National Radiology Data Registry, American College of Radiology. Size-specific dose estimate (SSDE), a dose estimate based on BW, CT dose index, dose-length product, and effective dose were analyzed. BW measurement was obtained with electronic calipers from the axial image at the splenic vein level after completion of the CT scan. An adult-sized patient was defined as a patient with BW of 34 cm. An appropriate dose range for each DRR was developed by reviewing image quality on a subset of CT scans through comparison with a five-point visual reference scale with increments of added simulated quantum mottle and by determining DRR to establish lower and upper bounds for each range. RESULTS: For 954 scans, DRRs (SSDEs) were 5.8-12.0, 7.3-12.2, 7.6-13.4, 9.8-16.4, and 13.1-19.0 mGy for BWs less than 15, 15-19, 20-24, 25-29, and 30 cm or greater, respectively. The fractions of adult doses, adult SSDEs, used within the consortium for patients with BWs of 10, 14, 18, 22, 26, and 30 cm were 0.4, 0.5, 0.6, 0.7, 0.8, and 0.9, respectively. CONCLUSION: The concept of DRRs addresses the balance between the patient's risk (radiation dose) and benefit (diagnostic image quality). Calculation of reference doses as a function of BW for an individual practice provides a tool to help develop site-specific CT protocols that help manage pediatric patient radiation doses.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

July 2013

Volume

268

Issue

1

Start / End Page

208 / 218

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Registries
  • Reference Values
  • Radiography, Abdominal
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Male
  • Infant, Newborn
 

Citation

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ICMJE
MLA
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Goske, M. J., Strauss, K. J., Coombs, L. P., Mandel, K. E., Towbin, A. J., Larson, D. B., … Prince, J. S. (2013). Diagnostic reference ranges for pediatric abdominal CT. Radiology, 268(1), 208–218. https://doi.org/10.1148/radiol.13120730
Goske, Marilyn J., Keith J. Strauss, Laura P. Coombs, Keith E. Mandel, Alexander J. Towbin, David B. Larson, Michael J. Callahan, et al. “Diagnostic reference ranges for pediatric abdominal CT.Radiology 268, no. 1 (July 2013): 208–18. https://doi.org/10.1148/radiol.13120730.
Goske MJ, Strauss KJ, Coombs LP, Mandel KE, Towbin AJ, Larson DB, et al. Diagnostic reference ranges for pediatric abdominal CT. Radiology. 2013 Jul;268(1):208–18.
Goske, Marilyn J., et al. “Diagnostic reference ranges for pediatric abdominal CT.Radiology, vol. 268, no. 1, July 2013, pp. 208–18. Pubmed, doi:10.1148/radiol.13120730.
Goske MJ, Strauss KJ, Coombs LP, Mandel KE, Towbin AJ, Larson DB, Callahan MJ, Darge K, Podberesky DJ, Frush DP, Westra SJ, Prince JS. Diagnostic reference ranges for pediatric abdominal CT. Radiology. 2013 Jul;268(1):208–218.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

July 2013

Volume

268

Issue

1

Start / End Page

208 / 218

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Registries
  • Reference Values
  • Radiography, Abdominal
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Male
  • Infant, Newborn