title: Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States.
abstract: BACKGROUND
  During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients.
  
  
  OBJECTIVE
  This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently.
  
  
  METHODS
  We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDIvol). SSDE was calculated and differences among groups were compared by regression analysis.
  
  
  RESULTS
  Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs.
  
  
  CONCLUSIONS
  Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged.
authors.affiliation: Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR 97239, USA. hopkinsk@ohsu.ed
authors.forename: Katharine L
authors.initials: KL
authors.lastname: Hopkins
authors.forename: David R
authors.initials: DR
authors.lastname: Pettersson
authors.forename: Caroline W
authors.initials: CW
authors.lastname: Koudelka
authors.forename: Kristopher
authors.initials: K
authors.lastname: Spinning
authors.forename: Petra L
authors.initials: PL
authors.lastname: Vajtai
authors.forename: Brooke R
authors.initials: BR
authors.lastname: Beckett
authors.forename: Dianna M E
authors.initials: DM
authors.lastname: Bardo
mesh_terms: D002648:Child; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011835:Radiation Protection / Q000592:standards* / Q000706:statistics & numerical data*; D012041:Regional Medical Programs / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review; D051598:Whole Body Imaging / Q000592:standards* / Q000706:statistics & numerical data*
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