title: Diagnostic reference levels in pediatric radiology in Austria.
abstract: BACKGROUND
  Because of the higher sensitivity to radiation in children, optimization plays an essential role in pediatric radiology. Diagnostic reference levels are a helpful tool to optimize patient dose for standard radiographic procedures.
  
  
  METHODS
  A nationwide survey was conducted to determine doses and variation in average dose applied to children for standard X-ray examinations. Dose values for chest, skull and abdomen X-ray procedures were determined for newborns, 1, 5, 10 and 15 year olds.
  
  
  RESULTS
  Third quartiles of patient doses are provided and compared to European, British and German reference values. Variation in average doses between hospitals (i.e., ratio of maximal to minimal applied average dose) for the same age and examination was found to be typically a factor of eight. Ratios of maximal to minimal applied doses to individual patients were found to be approximately a factor of six higher than variations of average doses between clinics.
  
  
  CONCLUSIONS
  While average patient doses indicate the use of good radiological practice in general, variance in average doses applied by different hospitals indicate that audit of dose with respect to reference values will provide guidance for optimization. Such practice should result in lowering doses for pediatric examinations.
authors.affiliation: Center for Biomedical Engineering and Physics, Medical University of Vienna, Vienna, Austria. Jochen.billinger@meduniwien.ac.at
authors.forename: Jochen
authors.initials: J
authors.lastname: Billinger
authors.forename: Robert
authors.initials: R
authors.lastname: Nowotny
authors.forename: Peter
authors.initials: P
authors.lastname: Homolka
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001317:Austria; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005060:Europe; D005858:Germany; D006761:Hospitals; D006801:Humans; D007223:Infant; D010372:Pediatrics; D011829:Radiation Dosage; D011835:Radiation Protection; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012016:Reference Values; D012886:Skull / Q000000981:diagnostic imaging; D006113:United Kingdom