Establishment of Computed Tomography Dose of Diagnostic Reference Levels for Sudanese Paediatrics Patients

Abstract

As children are special cases, where they have a risk two to four times higher than the late manifestations of the harmful effects of radiation, this study aimed to establish a level of acceptable exposure in accordance with international standards without compromising the reduction in the quality of medical imaging and information required from tests in what DRLS is called. This study was done in the period between June 2015 and even November 2018 and included 394 case of computed tomography for ages between 1 day and 16 years with their similarity of the complaint, in a single examination of head, chest, and abdomen-pelvis, according to the criteria traded on the work on 10 CT scan centers in Khartoum with needing of focused on the study of more centers and more frequency tests request in DRLS. The study was included all devices CT scan in these centers, which range between (2 slice to 128 Slice) for devices with different manufactures. Multiple statistical methods were used to represent the results and data for the calculation of DRLS for all statistical data, which was based on the concept of (DLP) and (CTDIV) basic units to establish a diagnostic reference dose for each center, and then to calculate the value located at the account (75%-3rd quartile) DRLS per centers and identify NDRL full range representing. Brain imaging children doses were the highest compared with the other available studies worldwide and were high compared with adult doses for the same country. High dose was due to the lack in selecting the appropriate factors and not to disregard the better ways to communicate with children patients. DRL for the brain by 75% value was (923mGy.cm). PNS showed highest values than those for adult ranges, in spite of the high dangerous of the eye lens doses, this was related to the same causes in the brain doses and in addition of less number of patients which gives less accurate results. The more increase of doses with 128 slice models. DRL in 75% value was proposed (603 mGy.cm). Chest showed more increase of dose ranges with 128 slice modality. DRLS in 75% value was proposed (430 mGy.cm). For the abdomen and pelvis, there were 96 patients, 22 of them were routine, 8 tri-phases Abdomen, and 66 were CTKUB. The DRLS in 75% value were (632, 768 and 366 mGy.cm) sequentially. Most of the patients were sent for CTKUB, so DRL 75% for the abdomen in this study was proposed (500 mGy.cm). The differences in doses in different sections and sometimes in the same section because of differences in the machines models and high doses were concerned with high slices numbers, lack deepening in the possibilities of modern equipment and in addition to the less consultation between the technician, radiologists and the doctor.