title: Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand.
abstract: OBJECTIVE
  To evaluate paediatric CT dosimetry in Australia and New Zealand and calculate size-specific dose estimates (SSDEs) for chest and abdominal examinations.
  
  
  METHODS
  Eight hospitals provided data from 12 CT systems for 1462 CTs in children aged 0-15. Imaging data were recorded for eight examinations: head (trauma, shunt), temporal bone, paranasal sinuses, chest (mass) and chest HRCT (high-resolution CT), and abdomen/pelvis (mass/inflammation). Dose data for cranial examinations were categorised by age and SSDEs by lateral dimension. Diagnostic reference ranges (DRRs) were defined by the 25th and 75th percentiles. Centralised image quality assessment was not undertaken.
  
  
  RESULTS
  DRRs for 201 abdominopelvic SSDEs were: 2.8-4.7, 3.6-11.5, 8.5-15.0, 7.6-15, and 10.6-16.2 for the <15 cm, 15-19 cm, 20-24 cm, 25-29 cm and >30 cm groups, respectively. For 147 chest examinations using these body width categories, SSDE DRRs were 2.0-4.4, 3.3-7.9, 4.0-9.4, 4.5-12, and 6.5-12. Kilovoltage peak (kVp), but not AEC or IR, was associated with SSDE (parameter estimate [standard error]: 0.12 (0.03); p < 0.0001).
  
  
  CONCLUSIONS
  Australian and New Zealand paediatric CT DRRs and abdominal SSDEs are comparable to international data. SSDEs for chest examinations are proposed. Dose variations could be reduced by adjusting kVp.
  
  
  CONCLUSIONS
  • SSDEs can be calculated for all patients, CT systems, and practices • Kilovoltage peak (kVp) has the greatest association with dose in similar-sized patients • Paediatric DRRs for CT are now available for use internationally.
authors.affiliation: Diagnostic Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Jackson
authors.affiliation: Diagnostic Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Atkin
authors.affiliation: Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: F
authors.initials: F
authors.lastname: Bettenay
authors.affiliation: Diagnostic Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Clark
authors.affiliation: Diagnostic Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.|Monash Children's, Clayton, Victoria, Australia.|Monash University, Clayton, Victoria, Australia.
authors.forename: M R
authors.initials: MR
authors.lastname: Ditchfield
authors.affiliation: Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Grimm
authors.affiliation: Women's and Children's Hospital, Adelaide, South Australia, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Linke
authors.affiliation: Royal Children's Hospital, Brisbane, Queensland, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Long
authors.affiliation: The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Onikul
authors.affiliation: Sydney Children's Hospital, Randwick, New South Wales, Australia.|The University of New South Wales, Kensington, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Pereira
authors.affiliation: Mater Children's Hospital, Brisbane, Queensland, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Phillips
authors.affiliation: Starship Children's Health, Auckland, New Zealand.
authors.forename: F
authors.initials: F
authors.lastname: Wilson
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Paul
authors.affiliation: Diagnostic Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia. Stacy.Goergen@monashhealth.org.|Department of Surgery, Southern Clinical School, Monash University, Clayton, Victoria, Australia. Stacy.Goergen@monashhealth.org.
authors.forename: S K
authors.initials: SK
authors.lastname: Goergen
mesh_terms: D000293:Adolescent; D001315:Australia; D049628:Body Size; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D009520:New Zealand; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging; D010388:Pelvis / Q000000981:diagnostic imaging; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000379:methods; D013902:Radiography, Thoracic / Q000379:methods; D011874:Radiometry; D012016:Reference Values; D013701:Temporal Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT, CT dose optimization; Diagnostic reference levels; Paediatrics; Radiation dose; Size-specific dose estimates (SSDEs)