Benchmarking pediatric cranial CT protocols using a dose tracking software system: a multicenter study.
OBJECTIVE
To benchmark regional standard practice for paediatric cranial CT-procedures in terms of radiation dose and acquisition parameters.


METHODS
Paediatric cranial CT-data were retrospectively collected during a 1-year period, in 3 different hospitals of the same country. A dose tracking system was used to automatically gather information. Dose (CTDI and DLP), scan length, amount of retakes and demographic data were stratified by age and clinical indication; appropriate use of child-specific protocols was assessed.


RESULTS
In total, 296 paediatric cranial CT-procedures were collected. Although the median dose of each hospital was below national and international diagnostic reference level (DRL) for all age categories, statistically significant (p-value < 0.001) dose differences among hospitals were observed. The hospital with lowest dose levels showed smallest dose variability and used age-stratified protocols for standardizing paediatric head exams. Erroneous selection of adult protocols for children still occurred, mostly in the oldest age-group.


CONCLUSIONS
Even though all hospitals complied with national and international DRLs, dose tracking and benchmarking showed that further dose optimization and standardization is possible by using age-stratified protocols for paediatric cranial CT. Moreover, having a dose tracking system revealed that adult protocols are still applied for paediatric CT, a practice that must be avoided.


CONCLUSIONS
• Significant differences were observed in the delivered dose between age-groups and hospitals. • Using age-adapted scanning protocols gives a nearly linear dose increase. • Sharing dose-data can be a trigger for hospitals to reduce dose levels.
Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650, Antwerp, Belgium. timo.debondt@gmail.com.
Timo
T
De Bondt
Department of Radiology, H. Hart Hospital, Mechelsestraat 24, 2500, Lier, Belgium.
Tom
T
Mulkens
GE Healthcare, DoseWatch, Rue de la Minière, Buc, 78530, France.|KU Leuven, Imaging and Pathology Department, Herestraat 49, Leuven, 3000, Belgium.
Federica
F
Zanca
Department of Radiology, AZ St. Jan Brugge-Oostende AV Hospital, Ruddershove 10, 8000, Brugge, Belgium.
Lotte
L
Pyfferoen
Department of Radiology, AZ St. Jan Brugge-Oostende AV Hospital, Ruddershove 10, 8000, Brugge, Belgium.
Jan W
JW
Casselman
Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650, Antwerp, Belgium.
Paul M
PM
Parizel
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols; D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003561:Cytarabine; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods*; D012015:Reference Standards; D012189:Retrospective Studies; D012984:Software; D013866:Thioguanine; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003561:Cytarabine; D013866:Thioguanine
Benchmarking; Computed tomography; Paediatric; Radiation dose; Standardization