Radiation Dose Evaluation for Pediatric Patients Undergoing Repeated Brain Computed Tomography Examination رسالة ماجستير

Abstract

Introduction: Children with neurological conditions often need repeated CT scans, which creates concerns about the long-term effects of accumulated radiation exposure. Additionally, because clinical practice varies, it is essential to optimize CT protocols. Purpose: This study aimed to compare scanner-recorded and calculated doses with estimates from standard pediatric and adult protocols, analyze how scan parameters changed across patient groups, evaluate CTDIvol, DLP, and effective dose in children undergoing repeated brain CT scans, and explore options for dose optimization. Methods: This retrospective study examines the radiation exposure associated with 68 pediatric patients who underwent two to four brain CT scans at Rafedia Surgical Hospital from 2021 to 2024. We used statistical analyses (correlations, Friedman test, paired tests) to compare dose indicators, examine changes across scans in different groups, and assess relationships between variables. Results: The findings of the study showed that the total effective dose increased as the number of scans increased. In addition, it found significant differences (p<0.001) between scanner-calculated effective doses and those estimated from pediatric and adult protocols. Clinical practice doses were much closer to the adult protocol estimates than to the pediatric estimates. If clinical practice followed the pediatric protocol more closely, the dose could reduce by about 13%. Conclusion: Repeated pediatric brain CT scans risk substantial radiation dose increases, especially after the second scan. Current practice often utilizes an adult setting instead of appropriate pediatric protocols. Adhering to optimized protocols and thoroughly justifying each repeat scan is essential to minimize children’s radiation exposure.