• Neige M Y Journy, Serge Dreuil, Nathalie Boddaert, Jean-François Chateil, Didier Defez, Hubert Ducou-le-Pointe, Jean-Marc Garcier, Joël Guersen, Bouchra Habib Geryes, Andreas Jahnen, Choonsik Lee, Jacqueline Payen-de-la-Garanderie, Jean-Pierre Pracros, Dominique Sirinelli, Isabelle Thierry-Chef, and Marie-Odile Bernier.
• Laboratoire d'épidémiologie des rayonnements ionisants, Unité Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France. njourny@netcourrier.fr.
• Eur Radiol. 2018 Feb 1; 28 (2): 630-641.

ObjectivesTo describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs).MethodsThe survey was conducted in radiology departments of six major university hospitals in France in 2010-2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms.ResultsCTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2-4 for most body parts, but 5-7 for abdominal examinations and 4-14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years).ConclusionThe results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children.Key Points • CTDIvol varied little with age for routine head scans.  • CTDIvol was lowest in youngest children for chest or abdominal scans.  • Individual and inter-department variability warrant enhanced standardisation of practices.  • Recent surveys support the need for revised diagnostic reference levels.  • More attention should be given to specific protocols (sinuses, neck, spine, mediastinum).

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