title: Effect of staff training on radiation dose in pediatric CT.
abstract: OBJECTIVE
  To evaluate the efficacy of staff training on radiation doses applied in pediatric CT scans.
  
  
  METHODS
  Pediatric patient doses from five CT scanners before (1426 scans) and after staff training (2566 scans) were compared statistically. Examinations included cranial CT (CCT), thoracic, abdomen-pelvis, and trunk scans. Dose length products (DLPs) per series were extracted from CT dose reports archived in the PACS.
  
  
  RESULTS
  A pooled analysis of non-traumatic scans revealed a statistically significant reduction in the dose for cranial, thoracic, and abdomen/pelvis scans (p<0.01). This trend could be demonstrated also for trunk scans, however, significance could not be established due to low patient frequencies (p>0.05). The percentage of scans performed with DLPs exceeding the German DRLs was reduced from 41% to 7% (CCT), 19% to 5% (thorax-CT), from 9% to zero (abdominal-pelvis CT), and 26% to zero (trunk; DRL taken as summed DRLs for thorax plus abdomen-pelvis, reduced by 20% accounting for overlap). Comparison with Austrian DRLs - available only for CCT and thorax CT - showed a reduction from 21% to 3% (CCT), and 15 to 2% (thorax CT).
  
  
  CONCLUSIONS
  Staff training together with application of DRLs provide an efficient approach for optimizing radiation dose in pediatric CT practice.
authors.affiliation: Medical University of Vienna, Department of Biological Imaging and Image-guided Therapy, Division of General and Paediatric Radiology, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Electronic address: azadeh.hojreh@meduniwien.ac.at.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Hojreh
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of General and Paediatric Radiology, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Electronic address: michael.Weber@Meduniwien.Ac.At.
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.affiliation: Medical University of Vienna, Centre for Medical Physics and Biomedical Engineering, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Electronic address: peter.Homolka@Meduniwien.Ac.At.
authors.forename: Peter
authors.initials: P
authors.lastname: Homolka
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007318:Inservice Training / Q000706:statistics & numerical data*; D008297:Male; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data; D010388:Pelvis / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000706:statistics & numerical data; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D011871:Radiology / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000592:standards / Q000706:statistics & numerical data*
keywords: CT DRL; Diagnostic reference levels; Pediatric computed tomography; Radiation protection; Staff training