The role of radiographers in ensuring dose optimisation for computed tomographic imaging in paediatric populations

Abstract

Abstract

Aim and Background The increasing use of CT to facilitate accurate diagnosis in children has become a considerable concern given the risks associated with ionising radiation exposure. Given the unique position of radiographers, but uncertainty regarding the best means to optimise radiation dose in paediatric CT practice, this systematic review sought to address this problem.

Methods A search for relevant literature was undertaken in November 2020 using appropriate search terms and the databases of MEDLINE, CINAHL and EMBASE. Searching was supplemented with citation screening and Google Scholar searching. Eligible studies were appraised using CASP and the results were synthesised narratively.

Results A total of nine studies were reviewed. Most studies observed a moderate risk of bias and varied applicability to the local context. The narrative synthesis revealed that the most effective options for radiographers to employ in paediatric CT practice are size and composition-based protocols, lowering the tube current and/or tube potential and iterative reconstruction as these yielded >50% reductions in radiation dose whilst preserving image quality for accurate diagnosis. Wider literature revealed additional means to optimisation radiation exposure in children, but survey research showed that radiographers’ knowledge levels regarding optimisation techniques was poor, due to a lack of ongoing education and training.

Conclusion Overall, it is imperative that radiographers are provided with such training, in order to improve adherence to dose optimisation techniques both locally and internationally