Pediatric Chest #CT Diagnostic Reference Ranges: Development and Application #ImageGently

Purpose
To determine diagnostic reference ranges on the basis of the size of a pediatric patient’s chest and to develop a method to estimate computed tomographic (CT) scanner–specific mean size-specific dose estimates SSDEs as a function of patient size and the radiation output of each CT scanner at a site.

Materials and Methods
The institutional review boards of each center approved this retrospective, HIPAA-compliant, multicenter study; informed consent was waived. CT dose indexes (#SSDE, volume #CT dose index, and dose length product) of 518 pediatric patients (mean age, 9.6 years; male patients, 277 [53%]) who underwent CT between July 1, 2012, and June 30, 2013, according to the guidelines of the #Quality Improvement Registry in CT Scans in Children were retrieved from a national #dose data registry. #Diagnostic reference ranges were developed after analysis of image quality of a subset of 111 CT examinations to validate image quality at the lower bound. Pediatric dose reduction factors were calculated on the basis of SSDEs for pediatric patients divided by SSDEs for adult patients.

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Results
Diagnostic reference ranges (SSDEs) were 1.8–3.9, 2.2–4.5, 2.7–5.1, 3.6–6.6, and 5.5–8.4 mGy for effective diameter ranges of less than 15 cm, 15–19 cm, 20–24 cm, 25–29 cm, and greater than or equal to 30 cm, respectively. The fractions of adult doses (pediatric dose reduction factors) used within the consortium for patients with lateral dimensions of 8, 11, 14, 17, 20, 23, 26, 29, 32, 35, and 38 cm were 0.29, 0.33, 0.38, 0.44, 0.50, 0.58, 0.66, 0.76, 0.87, 1.0, and 1.15, respectively.

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