Optimization of doses in radiopaediatrics during cystography and barium swallows of gastro-esophageal system

Objectives: The purpose of this study is the implementation of the optimization of patient doses in paediatric radiology for cystography and barium swallows of gastro-esophageal system. Equipment and methods: The study started with an evaluation of the current exposure levels based on 87 cystography and 70 barium swallows. The processes of dose optimization were tested on a phantom (applied high voltages, geometries of cells, image rates and removing the anti-scatter grid) to make sure of an acceptable quality of images for the diagnosis. A second evaluation of patient exposure (99 cystography and 59 barium swallow) allowed estimating the obtained reductions of radiation dose. Results: For 3 age groups (0-4 months, 4-23 months and 2-10 years), median DAP (Dose Area Product) was respectively reduced by a factor of 6, 2.9 and 2.3 for the cystography and by 2.8, 1.4 and 2 for barium swallow. Conclusion: This study allowed significant radiation doses reductions for these two examinations in radiopaediatrics. The quality of the radiological pictures was maintained at an acceptable level allowing the interpretation of examination. Finally, our data could possibly be integrated in a future national study on exposure levels in paediatrics.