Radiation Dose Management in Pediatric CT
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RADIATION EXPOSURE AND REDUCTION (J. DAMILAKIS, SECTION EDITOR)
Radiation Dose Management in Pediatric CT Francis R. Verdun • Leonor Alamo • Fre´de´ric A. Mie´ville • Franc¸ois Gudinchet
Published online: 28 December 2012 Springer Science+Business Media New York 2012
Abstract The rapid increase in the number of computed tomography (CT) scans performed has augmented concerns about safety risks. Although some of this increase is certainly legitimate and improves patient care, there is certainly still a need for dose reduction. Patients may insist on receiving a CT scan, and defensive medicine can certainly be a source of useless exposure. This means that the principle of justifying CT examinations needs to be reemphasized. Dealing with a properly justified examination is then a matter of image optimization aimed at providing the necessary diagnostic information at the lowest possible applied dose. The optimization of CT acquisition protocols involves teamwork in which manufacturers, legal bodies, radiologists, technologists, and medical physicists all play an important role. The purpose of this article is to review the latest progress in terms of the optimization of CT acquisition protocols in the pediatric population. Keywords Pediatric CT Radiation dose reduction Patient dose optimization Radiation Exposure
Introduction Diagnostic X-rays contribute about 25 % of the total (manmade plus natural) annual amount of radiation delivered to F. R. Verdun (&) F. A. Mie´ville Institute of Radiation Physics, University Hospital Center and University of Lausanne, Rue du Grand-Pre´ 1, 1007 Lausanne, Switzerland e-mail: [email protected] L. Alamo F. Gudinchet Department of Radiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland
the general population in Western countries, with computed tomography (CT) being the largest single source of these X-rays. Most patients certainly benefit from these CT examinations, but in the last 10 years their impact on the collective dose has drastically increased and, therefore, efforts are required to control this trend and to ensure that the risk–benefit ratio clearly lies on the benefit side [1–3]. The most efficient way to improve protection of the population from radiation in the field of medical imaging is, obviously, to focus on justifying examinations. This is a prerequisite to comply with regulations and certainly, at the moment, there is still a lack of consensus among certain indications for CT. Every effort should be made to optimize the acquisition protocols to avoid any waste of radiation dose. Within the process of optimization, it is essential that the dose reduction schemes proposed are verified to remain compatible over time with the production of images in which the integrity of the required diagnostic information is achieved. Since its introduction, CT has been subject to major technological progress and modern CT units provide both a short acquisition time and an excellent isotropic 3D spatial resolution. This has drasticall
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