title: Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction: clinical article.
abstract: OBJECTIVE
  In this study, the authors describe their experience with a low-dose head CT protocol for a preselected neurosurgical population at a dedicated pediatric hospital (Seattle Children's Hospital), the largest number of patients with this protocol reported to date.
  
  
  METHODS
  All low-dose head CT scans between October 2011 and November 2012 were reviewed. Two different low-dose radiation dosages were used, at one-half or one-quarter the dose of a standard head CT scan, based on patient characteristics agreed upon by the neurosurgery and radiology departments. Patient information was also recorded, including diagnosis and indication for CT scan.
  
  
  RESULTS
  Six hundred twenty-four low-dose head CT procedures were performed within the 12-month study period. Although indications for the CT scans varied, the most common reason was to evaluate the ventricles and catheter placement in hydrocephalic patients with shunts (70%), followed by postoperative craniosynostosis imaging (12%). These scans provided adequate diagnostic imaging, and no patient required a follow-up full-dose CT scan as a result of poor image quality on a low-dose CT scan. Overall physician comfort and satisfaction with interpretation of the images was high. An additional 2150 full-dose head CT scans were performed during the same 12-month time period, making the total number of CT scans 2774. This value compares to 3730 full-dose head CT scans obtained during the year prior to the study when low-dose CT and rapid-sequence MRI was not a reliable option at Seattle Children's Hospital. Thus, over a 1-year period, 22% of the total CT scans were able to be converted to low-dose scans, and full-dose CT scans were able to be reduced by 42%.
  
  
  CONCLUSIONS
  The implementation of a low-dose head CT protocol substantially reduced the amount of ionizing radiation exposure in a preselected population of pediatric neurosurgical patients. Image quality and diagnostic utility were not significantly compromised.
authors: Division of Neurosurgery, Seattle Children's Hospital, Seattle, Washington.
authors: Ryan P
authors: RP
authors: Morton
authors: Renee M
authors: RM
authors: Reynolds
authors: Rohan
authors: R
authors: Ramakrishna
authors: Michael R
authors: MR
authors: Levitt
authors: Richard A
authors: RA
authors: Hopper
authors: Amy
authors: A
authors: Lee
authors: Samuel R
authors: SR
authors: Browd
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D060733:Electromagnetic Radiation; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009922:Oregon; D010372:Pediatrics / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011829:Radiation Dosage; D040242:Risk Reduction Behavior; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends