title: Variation in Pediatric Cervical Spine Computed Tomography Radiation Dose Index.
abstract: OBJECTIVE
  The objective was to evaluate variation in the current estimated radiation dose index for pediatric cervical spine (c-spine) computed tomography (CT) examinations.
  
  
  METHODS
  This was a retrospective analysis of pediatric (age younger than 19 years) c-spine CT examinations from the American College of Radiology Dose Index Registry, July 2011 through December 2014. We used the volume CT dose index (CTDIvol) as the radiation dose estimate and used summary statistics to describe patient and hospital characteristics.
  
  
  RESULTS
  There were 12,218 pediatric CT c-spine examinations performed across 296 participating hospitals. Fifty-six percent were in male patients, and 79% were in children older than 10 years. Most hospitals (55%) were community hospitals without trauma designations, and the largest proportion of examinations (41%) were performed at these hospitals. The median CTDIvol was 15 mGy (interquartile range = 9 to 23 mGy) representing a more than 2.5-fold difference between the 25th and 75th percentiles. Pediatric hospitals (both trauma and nontrauma centers) delivered the lowest CTDIvol across all age groups and showed the least amount of variability in dose.
  
  
  CONCLUSIONS
  There is significant variation in the radiation dose index for pediatric c-spine CT examinations. Pediatric hospitals practice at lower CT dose estimates than other hospitals. Individual hospitals should examine their practices in an effort to ensure standardization and optimization of CT parameters to minimize radiation exposures to pediatric patients.
authors.affiliation: Department of Pediatrics and Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Marin
authors.affiliation: Department of American College of Radiology, Reston, VA.
authors.forename: Debapriya
authors.initials: D
authors.lastname: Sengupta
authors.affiliation: Department of American College of Radiology, Reston, VA.
authors.forename: Mythreyi
authors.initials: M
authors.lastname: Bhargavan-Chatfield
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Kalpana M
authors.initials: KM
authors.lastname: Kanal
authors.affiliation: Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Mills
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Applegate
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*