Program Information
Transitioning to Thickness-Based Protocols in Pediatric Abdomen Radiography
A Sanchez*, I Reiser , Y Zhang , J Finkle , Z Lu , K Feinstein , The University of Chicago, Chicago, IL
Presentations
PO-BPC-Exhibit Hall-23 (Saturday, March 18, 2017) Room: Exhibit Hall
Purpose: It has been widely asserted that age is a poor surrogate for patient size and that part-thickness-dependent protocols have potential to improve consistency of patient dose and image quality in pediatric radiography. By improving our understanding of current practices through analysis of technique factors and EI and prospectively tracking patient size for portable abdomen exams, we have taken important early steps in adopting part-thickness specific protocols.
Methods: We have analyzed 12 months of pediatric abdomen exams acquired with our portable radiography systems in both our children’s and adult hospitals. The comparison with adult hospitals serves as an indicator for the potential utility of protocol optimization in areas where pediatric imaging is performed infrequently. Meanwhile, we have begun to collect caliper-based thickness measurements for all portable abdomen exams performed in our pediatric hospital. These will be used to estimate patient-dependent variability in EI and patient dose consistency. We expect to have accrued over 1,000 cases for analysis to be presented at the 2017 Spring Clinical Meeting.
Results: The techniques used in our children’s hospital track the pre-programmed protocols closely, implying that technologists use default techniques as a reference. Nearly every protocol had significantly higher kVp or mAs in the adult hospitals. Consistency of EI for a given protocol was better for all pediatric exams in the children’s hospital, with the exception “ABD AP” which is an adult protocol occasionally used for pediatric patients.
Conclusion: We see that aged-based protocols result in disproportionate use across protocols, redundancy of protocols for small patients (i.e. ≤1 year), and large variability in dose and detector EI for protocols for older patients. Together with our prospective thickness measurements, however, the source of this variability can be better understood. Based on these results, protocols with thickness-based techniques and image processing are under development at our institution.
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