Local diagnostic reference levels of pediatric chest and abdominopelvic CT examinations based on body weight in central region of Saudi Arabia

Introduction: Establishing diagnostic reference levels (DRLs) for pediatric patients is more challenging than for adults due to the wide variation in their weight. To address this challenge, established guidelines recommend using pediatric weight categories in DRL surveys to enable accurate comparisons with previous data and facilitate effective radiation dose optimization. Objective: The aim of this study was to suggest weight-based DRLs for routine pediatric CT examinations, including the chest, abdomen, and pelvis. Materials and methods: 233 pediatric CT examination patients weighing 80 kg or less (81 chest, 124 abdomen & pelvis, and 28 chest, abdomen, and pelvis (CAP) CT scans) were categorized as follows: <5 kg; 15 kg (5 to <15 kg); 30 kg (15 to <30 kg); 50 kg (30 to <50 kg); 80 kg (50 to <80 kg). DRLs were set at the 75th percentile of CTDIvol and DLP and compared with other international published reports. Results: The 75% values of CTDIvol and DLP ranges were 3.46-9.04 mGy and 58.28-288.27 mGy cm for chest, 4.01-8.77 mGy and 162.43-466.37 mGy cm for abdomen & pelvis, and 2.91-4.67 mGy and 73.70-239.00 mGy cm, respectively, for CAP. Conclusion: The authors suggest local DRLs in the pediatric chest, abdomen & pelvis, and CAP CT scans according to body weight. Overall, our DRLs were generally higher than DRLs in other countries except Japan, where the values were comparable. Thus, it is crucial to optimize radiation parameters to minimize the radiation dose in children while maintaining acceptable image quality.