title: Radiation dose associated with CT-guided drain placement for pediatric patients.
abstract: BACKGROUND
  To date, there are limited radiation dose data on CT-guided procedures in pediatric patients.
  
  
  OBJECTIVE
  Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose.
  
  
  METHODS
  We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing.
  
  
  RESULTS
  Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv.
  
  
  CONCLUSIONS
  The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary.
authors.affiliation: Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA. Cody.Schwartz@unchealth.unc.edu.
authors.forename: Cody J
authors.initials: CJ
authors.lastname: Schwartz
authors.affiliation: Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Isaacson
authors.affiliation: Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA.
authors.forename: Lynn Ansley
authors.initials: LA
authors.lastname: Fordham
authors.affiliation: Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA.
authors.forename: Marija
authors.initials: M
authors.lastname: Ivanovic
authors.affiliation: Environment, Health and Safety, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: J Bradford
authors.initials: JB
authors.lastname: Taylor
authors.affiliation: Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Dixon
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT-guided drainage; Children; Computed tomography; Interventional radiology; Medical physics; Radiation dose