Image gently: Ten steps you can take to optimize image quality and lower CT dose for pediatric patients.

AJR:194, April 2010 This article suggests 10 steps that radiologists and radiologic technologists, with the assistance of their medical physicist, can take to obtain good quality CT images while properly managing radiation dose for children undergoing CT. The first six steps ideally should be completed before performing any CT on a pediatric patient. The final four steps address the unique consideration that should be given for each scanned patient.

[1]  CT dose and risk estimates in children , 2011, Pediatric Radiology.

[2]  Mahadevappa Mahesh Features to consider when selecting a new CT scanner. , 2010, Journal of the American College of Radiology : JACR.

[3]  Global quality imaging: improvement actions. , 2011, Journal of the American College of Radiology : JACR.

[4]  J. O'Daniel,et al.  Reducing radiation exposure from survey CT scans. , 2005, AJR. American journal of roentgenology.

[5]  M. Maher,et al.  Minimization of radiation exposure due to computed tomography in inflammatory bowel disease. , 2011, Clinics and research in hepatology and gastroenterology.

[6]  W. Huda Dose and image quality in CT , 2002, Pediatric Radiology.

[7]  Control and management of the radiation environment. , 2010, AJR. American journal of roentgenology.

[8]  M. Callahan,et al.  CT dose reduction in practice , 2011, Pediatric Radiology.

[9]  A. Duhaime,et al.  Common data elements for neuroimaging of traumatic brain injury: pediatric considerations. , 2012, Journal of neurotrauma.

[10]  G. Enríquez,et al.  Low-dose high-resolution CT of the chest in children and young adults: dose, cooperation, artifact incidence, and image quality. , 2000, AJR. American journal of roentgenology.

[11]  C A Kelsey,et al.  CT scanning: patterns of use and dose , 2000, Journal of radiological protection : official journal of the Society for Radiological Protection.

[12]  L. Donnelly Reducing radiation dose associated with pediatric CT by decreasing unnecessary examinations. , 2005, AJR. American journal of roentgenology.

[13]  C. Rumack 2010 ACR Presidential Address: Patient-focused radiology: taking charge of radiation dose. , 2010, Journal of the American College of Radiology : JACR.

[14]  J. Damilakis,et al.  Influence of z overscanning on normalized effective doses calculated for pediatric patients undergoing multidetector CT examinations. , 2007, Medical physics.

[15]  F. Gudinchet,et al.  Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality – preliminary findings , 2011, Pediatric Radiology.

[16]  D. Tudorascu,et al.  Low-Dose Nonenhanced Head CT Protocol for Follow-Up Evaluation of Children with Ventriculoperitoneal Shunt: Reduction of Radiation and Effect on Image Quality , 2008, American Journal of Neuroradiology.

[17]  Michael J Pentecost,et al.  American College of Radiology white paper on radiation dose in medicine. , 2007, Journal of the American College of Radiology : JACR.

[18]  A. Wainwright,et al.  A practical approach to the first iteration in the optimization of radiation dose and image quality in CT: estimates of the collective dose savings achieved. , 2001, The British journal of radiology.

[19]  J. Sanz,et al.  Imaging of congenital coronary artery anomalies , 2011, Pediatric Radiology.

[20]  Mervyn D. Cohen Searching for the holy grail: the pretense and fallacy of measuring CT radiation exposure in an individual patient. , 2011, Radiology.

[21]  John Damilakis,et al.  The effect of z overscanning on radiation burden of pediatric patients undergoing head CT with multidetector scanners: a Monte Carlo study. , 2006, Medical physics.

[22]  Edward Y Lee,et al.  Pulmonary embolism in pediatric patients survey of CT pulmonary angiography practices and policies. , 2010, Academic radiology.

[23]  Natalie N. Braun,et al.  Strategies for reducing radiation dose in CT. , 2009, Radiologic clinics of North America.

[24]  Donald P Frush,et al.  CT with a computer-simulated dose reduction technique for detection of pediatric nephroureterolithiasis: comparison of standard and reduced radiation doses. , 2009, AJR. American journal of roentgenology.

[25]  C. McCollough,et al.  Relationship between noise, dose, and pitch in cardiac multi-detector row CT. , 2006, Radiographics : a review publication of the Radiological Society of North America, Inc.

[26]  Aaron Sodickson,et al.  Strategies for reducing radiation exposure in multi-detector row CT. , 2012, Radiologic clinics of North America.

[27]  M. Ambrosino,et al.  Suspected appendicitis in children: focused CT technique for evaluation. , 2001, Radiology.

[28]  Geneviève Gaboriaud,et al.  Automatic exposure control in multichannel CT with tube current modulation to achieve a constant level of image noise: experimental assessment on pediatric phantoms. , 2007, Medical physics.

[29]  Mohamed Alfateh Badawy,et al.  Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study , 2009, The Lancet.

[30]  G. Taylor Suspected appendicitis in children: in search of the single best diagnostic test. , 2004, Radiology.

[31]  A. Berrington de González,et al.  Medical exposure to radiation and thyroid cancer. , 2011, Clinical oncology (Royal College of Radiologists (Great Britain)).

[32]  M. Mahesh Advances in CT technology and application to pediatric imaging , 2011, Pediatric Radiology.

[33]  S. Westra,et al.  The imaging of paediatric thoracic trauma , 2009, Pediatric Radiology.

[34]  M. Maher,et al.  Minimization of Radiation Exposure due to Computed Tomography in Inflammatory Bowel Disease , 2012, ISRN gastroenterology.

[35]  W Huda,et al.  Technique factors and image quality as functions of patient weight at abdominal CT. , 2000, Radiology.

[36]  M. Kalra,et al.  Strategies for CT radiation dose optimization. , 2004, Radiology.

[37]  D. Brenner,et al.  Computed tomography--an increasing source of radiation exposure. , 2007, The New England journal of medicine.

[38]  Survey of practice in paediatric computed tomography. , 2011, Radiation protection dosimetry.

[39]  U. Oyoyo,et al.  Ultra-low-dose protocol for CT-guided lung biopsies. , 2011, Journal of vascular and interventional radiology : JVIR.

[40]  Keith J Strauss,et al.  Image Gently Vendor Summit: working together for better estimates of pediatric radiation dose from CT. , 2009, AJR. American journal of roentgenology.

[41]  W. Huda,et al.  Effect of dose metrics and radiation risk models when optimizing CT x-ray tube voltage , 2008, Physics in medicine and biology.

[42]  S. Westra,et al.  Chest trauma in children: current imaging guidelines and techniques. , 2011, Radiologic clinics of North America.

[43]  S. Treves,et al.  Approaches to promotion and implementation of action on Radiation Protection for children. , 2011, Radiation protection dosimetry.

[44]  J. Ellis,et al.  Patterns of intravenous contrast material use and corticosteroid premedication in children—a survey of Society of Chairs of Radiology in Children’s Hospitals (SCORCH) member institutions , 2011, Pediatric Radiology.

[45]  G. A. P. Silva,et al.  Eliminating unenhanced CT when evaluating abdominal neoplasms in children. , 2007 .

[46]  A. Jung Medical radiation exposure in children and dose reduction , 2011 .

[47]  M. Pearce Patterns in paediatric CT use: An international and epidemiological perspective , 2011, Journal of medical imaging and radiation oncology.

[48]  J. Moses,et al.  Radiation is not the only risk. , 2011, AJR. American journal of roentgenology.

[49]  D. Frush Radiation, thoracic imaging, and children: radiation safety. , 2011, Radiologic clinics of North America.

[50]  D. Miglioretti,et al.  CTDIvol, DLP, and effective dose are excellent measures for use in CT quality improvement. , 2011, Radiology.

[51]  Ashok Panigrahy,et al.  Reducing abdominal CT radiation dose with the adaptive statistical iterative reconstruction technique in children: a feasibility study , 2011, Pediatric Radiology.

[52]  A S Brody,et al.  Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large Children's Hospital. , 2001, AJR. American journal of roentgenology.

[53]  Performance quality improvement projects: suggestions for radiologists who image children. , 2011, Journal of the American College of Radiology : JACR.

[54]  M. Smyth,et al.  Use of rapid-sequence magnetic resonance imaging for evaluation of hydrocephalus in children. , 2005, Journal of neurosurgery.

[55]  D. Fitzgerald,et al.  Pulmonary embolism in children. , 2012, Paediatric respiratory reviews.

[56]  D. Frush,et al.  Dose reduction in paediatric MDCT: general principles. , 2007, Clinical radiology.

[57]  Thomas L Toth,et al.  Dose reduction and compliance with pediatric CT protocols adapted to patient size, clinical indication, and number of prior studies. , 2009, Radiology.