Establishing local paediatric fluoroscopic diagnostic reference levels – a journey to benchmarking Australian doses

Yolanda Gomes, Greg Brown, Josephine Davies, Nayana Parange, Shayne Chau

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Abstract

Background: Diagnostic reference levels (DRLs) identify the administration of unusually high patient doses and are required for dose optimisation. Data concerning DRLs for paediatric fluoroscopic examinations in Australia is scarce. Objective: To compare DRLs for paediatric fluoroscopic examinations in a South Australian tertiary hospital to published data and promote the establishment of a national database for benchmarking paediatric doses. To explore relationships between dose area product (DAP), age and fluoroscopy time. Methods: The study was reviewed and given exemption by the hospital and university ethics boards. Dose data from 365 paediatric patients undergoing five fluoroscopic examinations were retrospectively analysed from a three-year period and age categorised for the development of local DRLs (LDRLs). Shapiro-Wilk’s test for normality was conducted. Relationships between DAP, age and fluoroscopy time were explored using scatter plots, Spearman’s correlation and regression tests. Results: LDRLs were significantly lower than published data, possibly reflecting technological and procedural advancements. Each one-year increase in age was associated with 0.77 μGy.m2 increase in DAP for barium meal and follow through studies, (95% CI = 0.055, 1.48) (P = 0.035), and 1.37 increase in DAP for barium swallow studies (95% CI = 0.61, 2.12) (P<0.001). Low correlation was demonstrated between DAP and fluoroscopy time for micturat-ing cystourethrography studies (r = 0.35, 95% CI = 0.15, 0.51, P<0.001) and barium meal and follow through studies (r = 0.37,95% CI = -0.011, 0.65, P = 0.050). Age and fluoroscopy time werenot significantly related. Conclusion: This study provides updated Australian paediatric fluo-roscopic DRLs, with the intention of promoting a national databasefor benchmarking paediatric doses.
Original languageEnglish
Pages (from-to)50-50
Number of pages1
JournalJournal of Medical Radiation Sciences
Volume69
Issue numberS1
DOIs
Publication statusPublished - May 2022

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