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Setting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead

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dc.contributor.authorCadavid, Lina
dc.contributor.authorKarout, Lina
dc.contributor.authorKalra, Mannudeep K.
dc.contributor.authorMorgado, Flavio
dc.contributor.authorLondoño, María Antonieta
dc.contributor.authorPérez-Marrero, Lizbet
dc.contributor.authorGaleano, Mónica
dc.contributor.authorMontaño, Mario
dc.contributor.authorWesley, Lavinia
dc.contributor.authorAlmanza, Judith
dc.contributor.authorPacheco, Walter
dc.contributor.authorGómez, Lucia
dc.contributor.authorMoscatelli, Antonio
dc.contributor.authorMuglia, Valdair
dc.contributor.authorKiipper, Felipe
dc.contributor.authorLucena, Ronaldo
dc.contributor.authorBernardo, Mónica
dc.contributor.authorUgas, Carlos
dc.date.accessioned2024-05-27T21:23:13Z
dc.date.available2024-05-27T21:23:13Z
dc.date.issued2023
dc.description.abstractWe established a framework for collecting radiation doses for head, chest and abdomen-pelvis computed tomography (CT) in children scanned at multiple imaging sites across Latin America with an aim towards establishing diagnostic reference levels (DRLs) and achievable doses (ADs) in pediatric CT in Latin America. Our study included 12 Latin American sites (in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Honduras and Panama) contributing data on the four most common pediatric CT examinations (non-contrast head, non-contrast chest, post-contrast chest and post-contrast abdomen-pelvis). Sites contributed data on patients’ age, sex and weight, scan factors (tube current and potential), volume CT dose index (CTDIvol) and dose length product (DLP). Data were verified, leading to the exclusion of two sites with missing or incorrect data entries. We estimated overall and site-specific 50th (AD) and 75th (diagnostic reference level [DRL]) percentile CTDIvol and DLP for each CT protocol. Non-normal data were compared using the Kruskal-Wallis test. Sites contributed data from 3,934 children (1,834 females) for different CT exams (head CT 1,568/3,934, 40%; non-contrast chest CT 945/3,934, 24%; post-contrast chest CT 581/3,934, 15%; abdomen-pelvis CT 840/3,934, 21%). There were significant statistical differences in 50th and 75th percentile CTDIvol and DLP values across the participating sites (P<0.001). The 50th and 75th percentile doses for most CT protocols were substantially higher than the corresponding doses reported from the United States of America. Our study demonstrates substantial disparities and variations in pediatric CT examinations performed in multiple sites in Latin America. We will use the collected data to improve scan protocols and perform a follow-up CT study to establish DRLs and ADs based on clinical indications.
dc.description.versionVersión publicada
dc.format.extent11 p.
dc.identifier.citationCadavid L, Karout L, Kalra MK, Morgado F, Londoño MA, Pérez L, Galeano M, Montaño M, Wesley L, Almanza J, Pacheco W, Gómez L, Moscatelli A, Muglia V, Kiipper F, Lucena R, Bernardo M, Ugas C. Setting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead. Pediatr Radiol. 2024 Mar;54(3):457-467. doi: 10.1007/s00247-023-05676-9
dc.identifier.doihttps://doi.org/10.1007/s00247-023-05676-9
dc.identifier.urihttps://hdl.handle.net/11447/8894
dc.language.isoen
dc.subjectChildren
dc.subjectComputed tomography
dc.subjectDose optimization
dc.subjectPatient safety
dc.subjectRadiation protection
dc.subjectReference values
dc.titleSetting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourcePediatric Radiology
dspace.entity.typePublication
relation.isAuthorOfPublicationc504faf8-5552-45f0-ac0e-f67ebf6cb231
relation.isAuthorOfPublication.latestForDiscoveryc504faf8-5552-45f0-ac0e-f67ebf6cb231

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