{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:57:12Z","timestamp":1787921832718,"version":"build-2784847793"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"20","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the radiation dose of chest computed tomography (CT) examinations of pediatric patients and the extent to which volume CT dose index (CTDIvol) underestimates radiation dose in comparison to size specific dose estimates (SSDE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-center, retrospective study of consecutive unenhanced pediatric (age\u00a0&amp;lt;18\u00a0years) chest CTs between October 2015 and October 2016. Radiation dose as well as demographic and clinical data were recorded from 133 chest CTs. Patients were grouped into 4 categories based on mean effective diameter of the chest. SSDE was generated for each patient according to the water equivalent and effective diameter and compared to CTDIvol. Factors associated with higher radiation doses were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CTDIvol underestimated radiation dose by 54.7%, 47.6%, 40.2%, and 31.2% (P\u00a0&amp;lt;\u00a0.001) for effective diameter groups 1 to 4, respectively, when compared to SSDE (calculated according to the water equivalent). When calculated according to the effective diameter, CTDIvol underestimated radiation dose by 47.6%, 39.4%, 27%, and 12.3% (P\u00a0&amp;lt;\u00a0.001) for effective diameter groups 1 to 4, respectively, when compared to SSDE. CT dose parameters, age, weight, Dw, and mean effective diameter were variables associated with higher radiation doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CTDIvol systematically underestimated radiation dose in comparison to SSDE in pediatric patients submitted to chest CT and should not be used as the primary parameter to monitor CT protocols in these patients. SSDE calculated according to effective diameter also underestimates the radiation dose compared to SSDE calculated based on water equivalent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rpd\/ncae212","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T11:34:02Z","timestamp":1728992042000},"page":"2008-2013","source":"Crossref","is-referenced-by-count":6,"title":["Radiation dose assessment of pediatric computed tomography of the chest: the need to consider patient size"],"prefix":"10.1093","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9866-9532","authenticated-orcid":false,"given":"Vanessa","family":"D\u00f6wich","sequence":"first","affiliation":[{"name":"Radiology Service , Hospital de Cl\u00ednicas de Porto Alegre, Ramiro Barcelos, 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre - RS, 90035-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-588X","authenticated-orcid":false,"given":"Felipe Soares","family":"Torres","sequence":"additional","affiliation":[{"name":"Radiology Service , Hospital de Cl\u00ednicas de Porto Alegre, Ramiro Barcelos, 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre - RS, 90035-903,","place":["Brazil"]},{"name":"Department of Medical Imaging, University of Toronto. Endere\u00e7o: 585 University Avenue , 1 PMB 274, Toronto, ON M5G 2N2,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andressa Lima","family":"Nietto","sequence":"additional","affiliation":[{"name":"Medical Physics and Radioprotection Department, Hospital de Cl\u00ednicas de Porto Alegre. Ramiro Barcelos , 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre, RS 90035-903,","place":["Brazil"]},{"name":"Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos , 2400 - Santa Cec\u00edlia, Porto Alegre, RS 90035-003,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor Silva","family":"Timm","sequence":"additional","affiliation":[{"name":"Medical Physics and Radioprotection Department, Hospital de Cl\u00ednicas de Porto Alegre. Ramiro Barcelos , 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre, RS 90035-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0624-1932","authenticated-orcid":false,"given":"Maur\u00edcio","family":"An\u00e9s","sequence":"additional","affiliation":[{"name":"Medical Physics and Radioprotection Department, Hospital de Cl\u00ednicas de Porto Alegre. Ramiro Barcelos , 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre, RS 90035-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Bacelar","sequence":"additional","affiliation":[{"name":"Medical Physics and Radioprotection Department, Hospital de Cl\u00ednicas de Porto Alegre. Ramiro Barcelos , 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre, RS 90035-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Jos\u00e9 Cauduro","family":"Mar\u00f3stica","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Sa\u00fade da Crian\u00e7a e do Adolescente, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos , 2400 - Santa Cec\u00edlia, Porto Alegre, RS 90035-003,","place":["Brazil"]},{"name":"Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos , 2400 - Santa Cec\u00edlia, Porto Alegre, RS 90035-003,","place":["Brazil"]},{"name":"Department of Pediatrics , Faculty of Medicine, , 2400 - Santa Cec\u00edlia, Porto Alegre, RS 90035-003,","place":["Brazil"]},{"name":"Universidade Federal do Rio Grande do Sul. Ramiro Barcelos , Faculty of Medicine, , 2400 - Santa Cec\u00edlia, Porto Alegre, RS 90035-003,","place":["Brazil"]},{"name":"Pediatric Pulmonology Unit, Hospital de Cl\u00ednicas de Porto Alegre. Ramiro Barcelos , 2350 Bloco A, Av. Prot\u00e1sio Alves, 211 - Bloco B e C - Santa Cec\u00edlia, Porto Alegre, RS 90035-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"2024121023333929000_ref1","first-page":"549","article-title":"NCRP report no. 160: ionizing radiation exposure of the population of the United States","volume-title":"Health Physics","author":"Maiello","year":"2010"},{"key":"2024121023333929000_ref2","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1007\/s00247-002-0671-1","article-title":"Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative","volume":"32","author":"Brenner","year":"2002","journal-title":"Pediatr Radiol"},{"key":"2024121023333929000_ref3","doi-asserted-by":"publisher","first-page":"289","DOI":"10.2214\/ajr.176.2.1760289","article-title":"Estimated risks of radiation-induced fatal cancer from pediatric CT","volume":"176","author":"Brenner","year":"2001","journal-title":"Am J Roentgenol"},{"key":"2024121023333929000_ref4","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1289\/ehp.1408548","article-title":"Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study","volume":"123","author":"Spycher","year":"2015","journal-title":"Environ Health Perspect"},{"key":"2024121023333929000_ref5","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1001\/jamapediatrics.2013.311","article-title":"The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk","volume":"167","author":"Miglioretti","year":"2013","journal-title":"JAMA Pediatr"},{"key":"2024121023333929000_ref6","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/S0140-6736(12)60815-0","article-title":"Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study","volume":"380","author":"Pearce","year":"2012","journal-title":"Lancet"},{"key":"2024121023333929000_ref7","volume-title":"Part 2\u201344: particular requirements for the safety of x-ray equipment for computed tomography. IEC publication no. 60601-2-44","author":"International Electrotechnical Commission Medical electrical equipment","year":"2002","edition":"2.1"},{"key":"2024121023333929000_ref8","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1148\/radiol.11101800","article-title":"CT dose index and patient dose: they are not the same thing","volume":"259","author":"Mccollough","year":"2011","journal-title":"Radiology"},{"key":"2024121023333929000_ref9","doi-asserted-by":"publisher","first-page":"540","DOI":"10.2214\/AJR.06.0101","article-title":"Patient radiation doses from adult and pediatric CT","volume":"188","author":"Huda","year":"2007","journal-title":"Am J Roentgenol"},{"key":"2024121023333929000_ref10","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1148\/radiol.12120131","article-title":"Investigation of American Association of Physicists in Medicine Report 204 size-specific dose estimates for pediatric CT implementation","volume":"265","author":"Brady","year":"2012","journal-title":"Radiology"},{"key":"2024121023333929000_ref11","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120131","article-title":"Use of water equivalent diameter for calculating patient size and size-specific dose estimates (SSDE) in CT: The Report of AAPM Task Group 220","year":"2014","journal-title":"AAPM Rep"},{"key":"2024121023333929000_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/hp.0b013e3181c80d20","volume-title":"NCRP Report No. 160: Ionizing Radiation Exposure of the Population of the United States","author":"Maiello","year":"2010"},{"key":"2024121023333929000_ref13","author":"DIR Executive Summary Report from the American College of Radiology","year":"2018"},{"key":"2024121023333929000_ref14","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1148\/radiol.2017161530","article-title":"Pediatric chest CT diagnostic reference ranges: development and application","volume":"284","author":"Strauss","year":"2017","journal-title":"Radiology"},{"key":"2024121023333929000_ref15","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1093\/rpd\/nct226","article-title":"The establishment of computed tomography diagnostic reference levels in Portugal","volume":"158","author":"Santos","year":"2014","journal-title":"Radiat Prot Dosim"},{"key":"2024121023333929000_ref16","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1093\/rpd\/ncr293","article-title":"Patient doses in paediatric CT: feasibility of setting diagnostic reference levels","volume":"147","author":"J\u00e4rvinen","year":"2011","journal-title":"Radiat Prot Dosim"},{"key":"2024121023333929000_ref17","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1118\/1.2713240","article-title":"The trouble with CTD100","volume":"34","author":"Boone","year":"2007","journal-title":"Med Phys"},{"key":"2024121023333929000_ref18","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1097\/01.HP.0000326333.42287.a2","article-title":"Medical radiation exposure in the U.S. in 2006: preliminary results","volume":"95","author":"Mettler","year":"2008","journal-title":"Health Phys"},{"key":"2024121023333929000_ref19","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1093\/oxfordjournals.rpd.a033130","article-title":"Reference doses for paediatric computed tomography","volume":"90","author":"Shrimpton","year":"2000","journal-title":"Radiat Prot Dosim"},{"key":"2024121023333929000_ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/oxfordjournals.rpd.a033130","article-title":"Doses from computed tomography (CT) examinations in the UK\u20142003 review","volume":"57","author":"Shrimpton","year":"2005","journal-title":"National Radiological Protection Board"},{"key":"2024121023333929000_ref21","doi-asserted-by":"publisher","first-page":"611","DOI":"10.2214\/AJR.07.2989","article-title":"Pediatric body MDCT: a 5-year follow-up survey of scanning parameters used by Pediatric radiologists","volume":"191","author":"Arch","year":"2008","journal-title":"Am J Roentgenol"},{"key":"2024121023333929000_ref22","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1093\/rpd\/ncs152","article-title":"French diagnostic reference levels in diagnostic radiology, computed tomography and nuclear medicine: 2004\u20132008 review","volume":"154","author":"Roch","year":"2013","journal-title":"Radiat Prot Dosim"},{"key":"2024121023333929000_ref23","author":"Bundesamt f\u00fcr Strahlenschutz","year":"2016"},{"key":"2024121023333929000_ref24","doi-asserted-by":"publisher","first-page":"1390","DOI":"10.1259\/bjr\/15839549","article-title":"Establishment of CT diagnostic reference levels in Ireland","volume":"85","author":"Foley","year":"2012","journal-title":"Br J Radiol"},{"key":"2024121023333929000_ref25","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1097\/01.HP.0000363840.78169.1b","article-title":"Effective dose variation in pediatric computed tomography: dose reference levels in Greece","volume":"97","author":"Yakoumakis","year":"2009","journal-title":"Health Phys"},{"key":"2024121023333929000_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/01.HP.0000363840.78169.1b","article-title":"IAEA (International Atomic Energy Agency). Radiation protection in paediatric radiology","volume":"71","year":"2012","journal-title":"Safety reports series"},{"key":"2024121023333929000_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncv414","article-title":"Paediatric CT exposure practice in the county of Rio De Janeiro: the need to establish diagnostic reference levels","volume":"171","author":"Jesus","year":"2015","journal-title":"Radiat Prot Dosim"},{"key":"2024121023333929000_ref28","doi-asserted-by":"publisher","first-page":"W384","DOI":"10.2214\/AJR.14.13241","article-title":"CT radiation dose and iterative reconstruction techniques","volume":"204","author":"Padole","year":"2015","journal-title":"Am J Roentgenol"},{"key":"2024121023333929000_ref29","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010388","article-title":"Extent of simultaneous radiation dose and iodine reduction at stable image quality in computed tomography of the chest","volume":"97","author":"Eller","year":"2018","journal-title":"Medicine"},{"key":"2024121023333929000_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2017.09.012","article-title":"CTPA protocol optimisation audit: challenges of dose reduction with maintained image quality","volume":"73","author":"Nania","year":"2018","journal-title":"Clin Radiol"},{"key":"2024121023333929000_ref31","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.860968","article-title":"Comparison of application value of different radiation dose evaluation methods In evaluating radiation dose of adult thoracic and abdominal CT scan","volume":"9","author":"He","year":"2022","journal-title":"Front Surg"}],"container-title":["Radiation Protection Dosimetry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/200\/20\/2008\/60967230\/ncae212.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/200\/20\/2008\/60967230\/ncae212.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T18:33:49Z","timestamp":1733855629000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rpd\/article\/200\/20\/2008\/7885130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":31,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,11,7]]},"published-print":{"date-parts":[[2024,12,6]]}},"URL":"https:\/\/doi.org\/10.1093\/rpd\/ncae212","relation":{},"ISSN":["0144-8420","1742-3406"],"issn-type":[{"value":"0144-8420","type":"print"},{"value":"1742-3406","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,11,7]]}}}