Purpose or Case Report: The principle of ALARA and its application in the pediatric population serves as the focus of the Image Gently campaign. Tertiary care institutions dedicated to the care of children are well situated to be regional leaders in maximizing the ALARA concept. This study compares the size-specific dose estimates of computed tomography (CT) studies performed at our institution to those from outside facilities referring patients for emergent care.
Methods & Materials: Our institution, a major pediatric referral center, is a large academic pediatric hospital that performs approximately as many CT exams of the abdomen and pelvis with contrast for acute abdominal pain as it receives consult requests for CT exams performed at referral centers. The SSDE of 20 consecutive contrast enhanced CT exams of the abdomen and pelvis performed at our institution were calculated and compared to 20 consecutive CT exams of the abdomen and pelvis with contrast submitted from outside referral facilities over the same time period. Size specific dose estimates (SSDE) of CTs of the abdomen and pelvis were calculated using established reference ranges based on patient size as defined by the AAPM¹.
Results: The mean SSDE for patients scanned at our institution was 10.31 (95% CI: 9.49-11.13). The mean SSDE for exams performed on studies at outside referral facilities was 28.12 (95% CI: 17.15-39.10). The average age and patient body size of our patient population were statistically similar.
Conclusions: These findings demonstrate that there is a significant decrease in SSDE of CT studies performed at our institution compared to outside referral institutions. This finding is important in highlighting the successful application of the optimization principle of ALARA at our institution. Furthermore, the degree of SSDE variability among referral institutions is important in showing that the choice of facility is likely a major determinant in radiation dose to children in the region. Outside facilities may benefit from additional training regarding dose optimization techniques in the pediatric population.