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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticlePatient Safety

Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States

G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush and K.E. Applegate
American Journal of Neuroradiology July 2018, DOI: https://doi.org/10.3174/ajnr.A5719
G. Sadigh
aFrom the Department of Radiology and Imaging Sciences (G.S., N.K.,), Emory University School of Medicine, Atlanta, Georgia
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N. Kadom
aFrom the Department of Radiology and Imaging Sciences (G.S., N.K.,), Emory University School of Medicine, Atlanta, Georgia
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P. Karthik
bAmerican College of Radiology (P.K., D.S.), Reston, Virginia
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D. Sengupta
bAmerican College of Radiology (P.K., D.S.), Reston, Virginia
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K. J. Strauss
cDepartment of Radiology (K.J.S.), University of Cincinnati School of Medicine, Cincinnati, Ohio
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D. Frush
dDepartment of Radiology (D.F.), Duke University Medical Center, Durham, North Carolina
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K.E. Applegate
eDepartment of Radiology (K.E.A.), University of Kentucky, Lexington, Kentucky.
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    FIG.

    Head CT examinations included in the study cohort from the DIR.

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    Table 1:

    Studies of radiation dose indices for pediatric noncontrast head CT

    StudyPublication YearTypeFindings
    Kanal et al212015National surveyPediatric hospitals had lower dose indices compared with general hospitals
    Kanal et al202011Washington State surveyLevel I–II trauma centers had lower dose indices compared with Levels III–V
    King et al192009Bi-institutional studiesRegional pediatric hospitals had lower dose indices compared with trauma centers
    Current study2018National study of ACR DIRPediatric hospitals had lower dose indices compared with other facility types
    Level I–II trauma centers had lower dose indices compared with level III–IV trauma centers or nontrauma hospitals
    Facilities in metropolitan areas had lower dose indices compared with urban and rural locations
    • Note:—ACR indicates American College of Radiology.

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    Table 2:

    Suggested dose-reduction strategies

    Roles of radiologists and imaging center staff
        Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric team including
            Pediatric radiologists
            Certified CT technologists with experience in pediatric populations
            Qualified medical physicists to help manage complex equipment
            Child life specialists to work with families of patients
        Frequent use of information created by the Image Gently Alliance regarding radiation dose reduction
    Referring clinician role
        Careful consideration of evidence-based clinical algorithms that can help assess the risk versus benefit of not obtaining a CT scan and choosing an imaging modality that provides necessary diagnostic information and does not use ionizing radiation
        Considering referring children to pediatric facilities when available
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Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States
G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush, K.E. Applegate
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5719
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Cite this article
G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush, K.E. Applegate
Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5719

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