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Article

Establishing Diagnostic Reference Levels for Paediatric CT Imaging: A Multi-Centre Study

by
Yassine Bouchareb
1,*,
Manar Al Kharusi
2,
Amani Al Maqbali
2,
Amal Al Maimani
3,
Hasina Al Maskari
4,
Srinivasa Rao Sirasanagandla
5,
Amna Al Jabri
1,
Faiza Al Kindi
4,
Saud Al Shabibi
4 and
Saleh Baawain
3
1
Department of Radiology and Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
2
Department of Physics, College of Science, Sultan Qaboos University, Muscat 123, Oman
3
Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat 123, Oman
4
Department of Radiology, Royal Hospital, Muscat 123, Oman
5
Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(14), 1728; https://doi.org/10.3390/healthcare13141728
Submission received: 13 April 2025 / Revised: 21 June 2025 / Accepted: 14 July 2025 / Published: 17 July 2025
(This article belongs to the Collection Radiology-Driven Projects: Science, Networks, and Healthcare)
Versions Notes

Abstract

Background: Computed Tomography (CT) imaging is widely recognised for its high capability in assessing multiple organs. However, concerns about patient radiation exposure, particularly in children, pose significant challenges. Objective: This study aimed to establish diagnostic reference levels (DRLs) for paediatric patients in the most common CT examinations to monitor and better control radiation doses. Methods: Dosimetry records from 5956 patients’ scans for the four most common CT imaging examinations—Head, Chest, Abdomen Pelvis (AP), and Chest Abdomen Pelvis (CAP)—were considered. The CT dosimetric quantities (CT dose-index volume (CTDIvol) and dose-length product (DLP)), along with patient demographics (age and weight), were collected from radiology data storage systems. DRLs for CTDIvol and DLP were determined for each imaging examination, stratified by patient age and weight groups, in accordance with ICRP recommendations. Results: The derived DRLs are presented as [median CTDIvol (mGy): median DLP (mGy·cm)]. For (<1 yr): Head: 13:187, Chest: 0.4:7, AP: 0.9:19, CAP: 0.4:10. For (1–5 yrs): Head: 16:276, Chest: 1:22, AP: 1.5:58, CAP: 1.6:63. For (6–10 yrs): Head: 19:332, Chest: 1.4:35, AP: 1.9:74, CAP: 2:121. For (11–15 yrs): Head: 21:391, Chest: 3:86, AP: 4.1:191, CAP: 3:165. We observed that both the CTDIvol and DLP DRL values increase with patient age. Weight-based DRLs follow similar trends for CTDIvol, while DLP values show noticeable variations in Chest and AP examinations. Conclusions: The study findings highlight the need for review and optimisation of certain scanning protocols, particularly for chest and AP examinations. The derived DRLs are consistent with findings from other studies. The study recommends establishing national paediatric DRLs to enhance radiology practice across the country and ensure adherence to international safety standards.
Keywords: diagnostic reference level; paediatric; computed tomography; CTDIvol; DLP diagnostic reference level; paediatric; computed tomography; CTDIvol; DLP

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MDPI and ACS Style

Bouchareb, Y.; Al Kharusi, M.; Al Maqbali, A.; Al Maimani, A.; Al Maskari, H.; Sirasanagandla, S.R.; Al Jabri, A.; Al Kindi, F.; Al Shabibi, S.; Baawain, S. Establishing Diagnostic Reference Levels for Paediatric CT Imaging: A Multi-Centre Study. Healthcare 2025, 13, 1728. https://doi.org/10.3390/healthcare13141728

AMA Style

Bouchareb Y, Al Kharusi M, Al Maqbali A, Al Maimani A, Al Maskari H, Sirasanagandla SR, Al Jabri A, Al Kindi F, Al Shabibi S, Baawain S. Establishing Diagnostic Reference Levels for Paediatric CT Imaging: A Multi-Centre Study. Healthcare. 2025; 13(14):1728. https://doi.org/10.3390/healthcare13141728

Chicago/Turabian Style

Bouchareb, Yassine, Manar Al Kharusi, Amani Al Maqbali, Amal Al Maimani, Hasina Al Maskari, Srinivasa Rao Sirasanagandla, Amna Al Jabri, Faiza Al Kindi, Saud Al Shabibi, and Saleh Baawain. 2025. "Establishing Diagnostic Reference Levels for Paediatric CT Imaging: A Multi-Centre Study" Healthcare 13, no. 14: 1728. https://doi.org/10.3390/healthcare13141728

APA Style

Bouchareb, Y., Al Kharusi, M., Al Maqbali, A., Al Maimani, A., Al Maskari, H., Sirasanagandla, S. R., Al Jabri, A., Al Kindi, F., Al Shabibi, S., & Baawain, S. (2025). Establishing Diagnostic Reference Levels for Paediatric CT Imaging: A Multi-Centre Study. Healthcare, 13(14), 1728. https://doi.org/10.3390/healthcare13141728

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