{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T05:16:17Z","timestamp":1764479777995,"version":"3.46.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T00:00:00Z","timestamp":1752969600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005778","name":"Central University of Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005778","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Computed tomography (CT) poses a concern in pediatric patients because of their higher sensitivity to radiation. At the time of the study, nephroblastoma was the most prevalent clinical indication for abdominal CT examinations in pediatric patients. Therefore, the aim of this study was to establish pediatric typical diagnostic reference levels (DRLs) for contrast\u2010enhanced abdominal CT examinations of pediatric patients presenting with nephroblastoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The volume CT dose index (CTDI\n                      <jats:sub>vol<\/jats:sub>\n                      ), dose\u2010length product (DLP) and patient weight of 121 patients with nephroblastoma were collected retrospectively. Size\u2010specific dose estimates (SSDE), CTDI\n                      <jats:sub>vol<\/jats:sub>\n                      and DLP were used to calculate DRL values. The SSDE was added as an additional parameter because dose estimates based on the patient's size are considered more precise. Patients were categorized into five weight groups for which DRL values were established per group. The pediatric DRL values in this study were set at the median of the data distribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnostic reference level values were only established for two weight groups that adhered to the International Commission on Radiological Protection (ICRP) guidelines. The DRL values for CTDI\n                      <jats:sub>vol<\/jats:sub>\n                      ranged from 2.4 to 2.7\u2009mGy, while the DLP ranged from 78.4 to 108\u2009mGy.cm, and SSDE\n                      <jats:sub>sum<\/jats:sub>\n                      ranged from 4.9 to 5.6\u2009mGy. The DRL values of this study were lower than the European Commission (EC) DRL values and higher than those of other international studies. The lower DRL values of this study will be used to further tailor the radiation dose to be lower than usual for optimization of the radiation dose received by pediatric patients for CT abdomen examinations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For efficient dose optimization, clinical indication, body weight, and SSDE should be considered when developing pediatric DRL values. Future optimization strategies will benefit from adapting patient size and clinical indication as suggested and supported by the findings of this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.70916","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T04:14:35Z","timestamp":1753071275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Indication\u2010Based Pediatric Diagnostic Reference Level Values for Abdominal Computed Tomography: A Descriptive Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-2935","authenticated-orcid":false,"given":"Tebello","family":"Pitso","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Health and Environmental Sciences Central University of Technology, Free State Bloemfontein South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida\u2010Keshia","family":"Sebelego","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Health and Environmental Sciences Central University of Technology, Free State Bloemfontein South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1362-4299","authenticated-orcid":false,"given":"Henra","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Health and Environmental Sciences Central University of Technology, Free State Bloemfontein South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2015.04.027"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HP.0000000000000758"},{"issue":"3","key":"e_1_2_12_4_1","first-page":"415","article-title":"Estimation of Diagnostic Reference Levels for Children Computed Tomography: A Study in Tehran, Iran","volume":"17","author":"Afzalipour R.","year":"2019","journal-title":"International Journal of Radiation Research"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncv044"},{"issue":"2","key":"e_1_2_12_6_1","first-page":"118","article-title":"Radiation Dose in Paediatric Computed Tomography: Risks and Benefits","volume":"8","author":"Ogbole G. 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