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Pediatric Dose-Reduction Protocols for Head CT: Do Hospitals Use Them?


Use of pediatric dose-reduction protocols and shielding for CTs vary among hospitals.

Over 90 percent of surveyed community hospitals in the U.S. used pediatric protocols for head CTs but not as many use shielding, according to an article published in the Journal of the American College of Radiology.

Researchers from Washington State University in Spokane examined hospital-level factors associated with the use of dedicated pediatric dose-reduction protocols by sending out surveys (online and paper) to a stratified random sample of community hospitals. The survey focused on CT scans for head trauma among children.

A total of 751 hospitals were approached and 253 responded for a response rate of 35.5 percent. Of the respondents, 92.6 percent reported that they used a pediatric dose-reduction protocol. Of 251 that used external shielding, 176 (70.1 percent) used the shielding for CT head and neck imaging.

Free–response indication of organs shielded:

Hospitals that reported shielding
Eye lens
14 percent
38 percent
19 percent
31 percent
Torso shield
49 percent

“Small hospitals (0 to 50 beds) were 20 percent less likely to report using a protocol than large hospitals (more than 150 beds). Teaching hospitals were more likely to report using a protocol,” the authors wrote. “After adjusting for covariates, children's hospitals were significantly less likely to report using protective shielding than nonchildren's hospitals, though this may be due to more advanced scanner type.”

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