| Abstract [eng] |
Justification of the work Computed tomography is a highly informative, accurate, accessible and quickly performed non-invasive X-ray diagnostic method. Its application has been continuously increasing over the past two decades. Computed tomography is responsible for the majority of the total collective effective dose experienced by patients. Children are particularly sensitive to the adverse effects of ionizing radiation, leading to an increase in risk of developing oncological diseases. Diagnostic reference levels are the main clinical tool for monitoring and optimizing dose quantities. However, currently there are no published national diagnostic reference levels for paediatric chest, abdominal-pelvic computed tomography examinations. Aim and objectives of the study The aim of this study is to assess the radiation exposure of patients undergoing paediatric chest and abdominal-pelvic computed tomography examinations. Research objectives: to evaluate the risks associated with computed tomography examinations presented in the literature, to assess the indications and the radiation doses received during paediatric chest, abdominal and pelvic examinations according to the weight of the patients, and to establish local diagnostic reference levels and compare their values with the values proposed in the literature. Research methods A data set of chest and abdominal and pelvic computed tomography examinations performed on children was analysed. Data records were grouped according to the weight of the patients in the following intervals: 5 to 14 kg, 15 to 29 kg, 30 to 49 kg and 50 to 79 kg. For each weight group, the minimum, first quartile, median, third quartile and maximum values of the product of the volumetric computed tomography dose index and the dose length were calculated. Local typical values and diagnostic reference levels were determined. The relationship between the dose size and the patient weight was estimated using exponential curves. A literature search was performed in the PubMed database. Results Local diagnostic reference levels for chest computed tomography examinations have been established. The proposed values are 2.0, 2.4, 3.6 and 5.0 mGy based on the volumetric computed tomography dose index and 40, 60, 116 and 156 mGy cm based on the dose-length product in the respective weight groups of 5 to 14 kg, 15 to 29 kg, 30 to 49 kg and 50 to 79 kg. Exponential curves of typical doses and diagnostic reference levels for different dose indices are presented for paediatric chest and abdominal and pelvic examinations. Conclusions The established local diagnostic reference levels for the chest and median dose values for abdominal and pelvic computed tomography scans are generally lower than the European diagnostic reference levels and similar to the diagnostic reference levels in other countries. Exponential curves serve the same function as the weight-group diagnostic reference levels, which are commonly used to estimate exposure. |
