Paediatric CT Dose Optimization in a General Hospital

Vivian Heidorne Guerra, Denise Yanikian Nersissian, Camila Souza Melo, Caio Vasconcellos, Rebeca Gonçalves Freitas, Márcio Sawamura, Eloisa Gebrim, Paulo Roberto Costa

Resumo


This work presents a methodology for the optimization of protocols applied to pediatric patients who underwent brain and chest computed tomography examinations. The implementation of this methodology aims to reduce the dose of ionizing radiation delivered to patients and the consequent risk associated with radiation, without decreasing the diagnostic image quality. The comparison between the results of CTDIvol (computed tomography dose index) and DLP (dose-length product) dosimetric quantities before the optimization process and their corresponding results after the implementation of the optimization process was done through boxplot graphs. It is noteworthy that the implementation of this methodology allows reductions in the range between 18 and 50% of the dosimetric values evaluated in this study. In addition, the case of brain computed tomography scans, in which the cohort of the evaluated patients is larger, is a highlight, which should also reflect in the reduction of the absorbed radiation dose by this particularly important group of patients.


Palavras-chave


otimização; pediatria; tomografia-computadorizada.

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Referências


IAEA. Dosimetry in Diagnostic Radiology for Paediatric Patients. Viena: International Atomic Energy Agency, 2013.

IAEA. Comprehensive Clinical Audits of Diagnostic Radiology Practices: A Tool for Quality Improvement - Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL). Vienna INTE RNATIONAL ATO MIC ENERGY AGENCY,, 2010.

Strauss KJ, Somasundaram E, Sengupta D, Marin JR, Brady SL. Radiation Dose for Pediatric CT: Comparison of Pediatric versus Adult Imaging Facilities. Radiology.0(0):181753. PubMed PMID: 30720404.

Goske MJ, Applegate KE, Boylan J, Butler PF, Callahan MJ, Coley BD, et al. The Image Gently Campaign: Working Together to Change Practice. American Journal of Roentgenology. 2008 2008/02/01;190(2):273-4.

Strauss KJ, Frush DP, Goske MJ. Image Gently campaign: making a world of difference. MEDICAL PHYSICS. 2015;3(2).

Brink JA, Amis Jr ES. Image Wisely: a campaign to increase awareness about adult radiation protection. Radiological Society of North America, Inc.; 2010.

IAEA/WHO. Bonn Call for Actions: 10 Actions to Improve Radiation Protection in Medicine in the Next Decade - Joint Position Statement by the IAEA and WHO. International atomic Energy Agency and World Health Organization, 2012 Contract No.: http://www.who.int/ionizing_radiation/medical_exposure/bonncallforaction2014.pdf.

Costa PR, dos Santos AASMD, de Sá LV, Schelin HR, Kotzian C, Magalhães LAG, et al. Brasil: C all for actions. CBR Newsletter [Internet]. 2018. Available from: https://cbr.org.br/brasil-call-actions/.

Hall EJ. Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatric Radiology. 2002 October 01;32(10):700-6.

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. PubMed PMID: WOS:000320761400023.

Giansante L, Nersissian DY, Melo CS, Sawamura MM, Costa PR, editors. Estudo comparativo de níveis de referência em diagnóstico (DRL) em procedimentos de tomografia computadorizada pediátrica. Congresso Brasileiro de Física Médica; 2017; Ribeirão Preto: ABFM.

ICRP. Diagnostic reference levels in medical imaging. CRP Publication 135 Ann ICRP 46(1)2017.

Costa PR, Yoshimura EM, Nersissian DY, Melo CS. Correlation between effective dose and radiological risk: general concepts. Radiol Bras. 2016;49(3):5.

Giansante L, Martins JC, Nersissian DY, Kiers KC, Kay F, Sawamura MVY, et al. Organ doses evaluation for chest computed tomography procedures with TL dosimeters: Comparison with Monte Carlo simulations. Journal of Applied Clinical Medical Physics. 2018.

Lee C, Kim KP, Bolch WE, Moroz BE, Folio L. NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans. Journal of Radiological Protection. 2015;35(4):891-909.

Seibert JA, Boone JM, Wootton-Gorges SL, Lamba R. Dose Is Not Always What It Seems: Where Very Misleading Values Can Result From Volume CT Dose Index and Dose Length Product. Journal of the American College of Radiology. 2014;11(3):233-7.

Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard J-A, et al. Strategies for CT Radiation Dose Optimization. Radiology. 2004;230(3):619-28. PubMed PMID: 14739312.

Charnock P, Dunn AF, Moores BM, Murphy J, Wilde R. Establishment of a comprehensive set of regional DRLS for CT by means of electronic x-ray examination records. Radiation Protection Dosimetry. 2015 Mar;163(4):509-20. PubMed PMID: WOS:000352538900014.

Dance DR, Christofides S, Maidment ADA, McLean ID, Ng K-H. Diagnostic Radiology Physics: A Handbook for Teachers and Students: International Atomic Energy Agency; 2014.

AAPM. THE ALLIANCE FOR QUALITY COMPUTED TOMOGRAPHY: American Association of Physicists in Medicine; 2018 [cited 2018 Oct 30]. ROUTINE PEDIATRIC CHEST CT PROTOCOLS].




DOI: http://dx.doi.org/10.29384/rbfm.2019.v13.n1.p138-144

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Direitos autorais 2019 Revista Brasileira de Física Médica



Revista Brasileira de Física Médica - RBFM

ISSN: 1984-9001

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