Paediatric chest diagnostic reference levels for three Northern Cape radiology departments

Abstract

Introduction: The risk of damaging radiation effects is higher in children because they have a longer life expectancy than adults. International radiation protection organisations emphasise the importance of dose optimisation. One tool that can be used to optimise the dose that a paediatric patient may receive from a radiological examination is called a diagnostic reference level. Purpose: This study aimed to develop paediatric diagnostic reference levels (PiDRLs) for anteroposterior (AP) chest imaging for radiology departments in the Northern Cape Province (NCP). Methods and materials: For this study, three radiology departments were investigated across four hospitals in the Northern Cape Province of South Africa. Paediatric patients frequently visit these research sites for radiological imaging. The purpose of this study was to create PiDRLs for three radiology departments in the Northern Cape province of South Africa. The researcher calculated the PiDRL for AP chest radiological examinations. PiDRLs were calculated by weight bands and age groups for all three NCP radiology departments. The researcher made use of a prospective and retrospective study design to reach the appropriate sample size for each weight band and age group. The sample size of 375 paediatric patients ranged from 0 to less than 12 years of age. DRLs are equipment specific, and therefore manufacturers of Siemens, Shimadzu and Dell were included in the research study. An image quality evaluation was conducted on the mobile units and X-ray equipment used by the departments to image paediatric patients. The researcher used a PBU-80 Newborn Whole Body, and the exposures as usually set by the radiographers. A comparison was also made to PiDRLs and variables in other studies, as reported in the literature. Results: The 75th percentile in weight groups and corresponding age groups are presented in the tables. The values are measured in units of milligray (mGy). The PiDRL for weight group 50kg to less than 80kg could not be calculated due to insufficient data for hospitals 1, 2a, and 2b. Further, the research could not calculate the PiDRL for the age group 10 years to less than 12 years in Hospital 2b for the Siemens x-ray equipment due to insufficient data. The image quality results were evaluated on the image criteria, and the scoring of the images was based on the assessment image quality 7-point scoring card issued by the European Commission in 1996. The results revealed that all the AP CXR images were of high quality. The 75th percentile of this research study was somewhat higher compared to international studies, but the PiDRLs, on the other hand, were consistent with the European Diagnostic reference levels (EDRLs). Conclusions: The PiDRLs were calculated for different age and weight groups for three radiology departments in four NCP hospitals. PiDRLs could not be calculated on the mobile units due to time constraints, but an image quality analysis was conducted. The PiDRLs calculated in this study were also consistent with international studies. However, this research study showed that the DRL could be revised and lowered in certain weight groups.