Diagnostic Reference Levels in Pediatric Cardiac CT Imaging: A Literature Review

MA Khafaji, SK Albahiti

International Journal of Biomedicine. 2023;13(4):207-212.
DOI: 10.21103/Article13(4)_RA2
Originally published December 5, 2023


Background: Children are more sensitive to ionizing radiation than adults, with tissue sensitivity inversely proportional to age. The high sensitivity is due to their long life expectancy and rapidly dividing cells. Cardiac computed tomography (CCT) exposes patients to high doses of radiation, compared to other conventional examinations. Diagnostic reference levels (DRLs) were introduced to reduce unnecessary radiation exposure while maintaining image quality. This study intended to review the current literature regarding pediatric radiation dose during CCT examination and assess the role of DRL in patients' dose reduction.
Methods and Results: This review includes articles published on PubMed and Google Scholar between 2013 and 2022. Articles were screened to ensure their suitability for the review purpose of establishing the DRLs and the methods used. Five articles that include both simulated and actual relevant data were reviewed. Doses during CCT ranged from 0.2 mSv to 28 mSv depending on the type of procedure, patient's age and weight, scan length, and imaging protocol. This wide range showed that pediatric doses are not yet optimized, although studies follow guidelines established for pediatric DRLs. Similar studies need to be conducted to audit and renew pediatric DRLs.

computed tomography • cardiac computed tomography • pediatric diagnostic reference levels
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Received July 27, 2023.
Accepted November 9, 2023.
©2023 International Medical Research and Development Corporation.