Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand

Objectives To evaluate paediatric CT dosimetry in Australia and New Zealand and calculate size-specific dose estimates (SSDEs) for chest and abdominal examinations. Methods Eight hospitals provided data from 12 CT systems for 1462 CTs in children aged 0–15. Imaging data were recorded for eight examinations: head (trauma, shunt), temporal bone, paranasal sinuses, chest (mass) and chest HRCT (high-resolution CT), and abdomen/pelvis (mass/inflammation). Dose data for cranial examinations were categorised by age and SSDEs by lateral dimension. Diagnostic reference ranges (DRRs) were defined by the 25th and 75th percentiles. Centralised image quality assessment was not undertaken. Results DRRs for 201 abdominopelvic SSDEs were: 2.8–4.7, 3.6–11.5, 8.5–15.0, 7.6–15, and 10.6–16.2 for the <15 cm, 15–19 cm, 20–24 cm, 25–29 cm and >30 cm groups, respectively. For 147 chest examinations using these body width categories, SSDE DRRs were 2.0–4.4, 3.3–7.9, 4.0–9.4, 4.5–12, and 6.5–12. Kilovoltage peak (kVp), but not AEC or IR, was associated with SSDE (parameter estimate [standard error]: 0.12 (0.03); p < 0.0001). Conclusions Australian and New Zealand paediatric CT DRRs and abdominal SSDEs are comparable to international data. SSDEs for chest examinations are proposed. Dose variations could be reduced by adjusting kVp. Key Points • SSDEs can be calculated for all patients, CT systems, and practices • Kilovoltage peak (kVp) has the greatest association with dose in similar-sized patients • Paediatric DRRs for CT are now available for use internationally