{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:07:15Z","timestamp":1779127635049,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann ICRP"],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      [Background] Although \u2018justification\u2019 and \u2018optimisation\u2019 are recommended as principles for reducing paediatric medical exposure, it is unclear whether these are actually implemented in general hospitals. [Method] Targeting emergency hospitals in the Tokyo area, we conducted a survey on the current status of paediatric acute abdomen, including diagnostic imaging methods used by physicians (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009169) and exposure doses from CT scans employed by radiology technologists (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009172). [Results] Fewer than half of physicians were aware of the guidelines for acute appendicitis, and utilisation was very low at 17%. However, ultrasound was the most commonly performed first imaging test at 77%. On the other hand, among technologists, 93% were aware of Japan's diagnostic reference level (DRL), and optimisation was applied at 83% of facilities. Otherwise, there were some facilities that used high-dose settings that exceeded the DRL, indicative of a trend towards a long-tailed distribution. [Discussion] Although awareness of the diagnostic guidelines was low, they were already being justified in general hospitals. As the guidelines become more widely known, the number of CT imaging phases may be further reduced. DRL was widely used and optimised. However, some facilities used high radiation settings, and these cannot be ignored.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01466453251412501","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:20:57Z","timestamp":1778692857000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Justification and optimisation of paediatric CT in prefectures around Tokyo"],"prefix":"10.1177","author":[{"given":"R.","family":"Okamoto","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Tsutsumi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Miyasaka","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Nosaka","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.05.018"},{"key":"e_1_3_1_3_1","first-page":"467","article-title":"Justification and optimization of CT in children: how are we performing? Pediatr","volume":"41","author":"Frush DP.","year":"2011","unstructured":"Frush DP. 2011. Justification and optimization of CT in children: how are we performing? Pediatr. Radiol 41, 467\u2013471.","journal-title":"Radiol"},{"key":"e_1_3_1_4_1","first-page":"13","article-title":"Radiological protection in paediatric diagnostic and interventional radiology. ICRP Publication 121, Ann","volume":"42","author":"ICRP","year":"2013","unstructured":"ICRP. 2013. Radiological protection in paediatric diagnostic and interventional radiology. ICRP Publication 121, Ann. ICRP 42, 13\u201314.","journal-title":"ICRP"},{"key":"e_1_3_1_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rrx095"},{"key":"e_1_3_1_6_1","first-page":"385","volume-title":"Diagnostic Imaging Guidelines","author":"Japan Radiological Society (Eds.)","year":"2016","unstructured":"Japan Radiological Society (Eds.). 2016. Diagnostic Imaging Guidelines. Kanehara Co. Ltd., Tokyo. pp. 385\u2013386 (in Japanese)."},{"key":"e_1_3_1_7_1","first-page":"59","volume-title":"Evidence-Based Guidelines for the Emergency Management of the Abdomen in Children (in Japanese)","author":"Japanese Society of Emergency Pediatrics (Eds.)","year":"2017","unstructured":"Japanese Society of Emergency Pediatrics (Eds.). 2017. Evidence-Based Guidelines for the Emergency Management of the Abdomen in Children (in Japanese). Japanese Society of Emergency Pediatrics, Tokyo. pp. 59\u201364."},{"key":"e_1_3_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60815-0"},{"key":"e_1_3_1_9_1","volume-title":"2021\/2021 Report Volume I, Annex A: Evaluation of Medical Exposure to Ionizing Radiation, Electronic Attachments: A-3. Summary for Modelling Global Frequencies of Medical Exposure","author":"UNSCEAR","year":"2022","unstructured":"UNSCEAR. 2022. 2021\/2021 Report Volume I, Annex A: Evaluation of Medical Exposure to Ionizing Radiation, Electronic Attachments: A-3. Summary for Modelling Global Frequencies of Medical Exposure. New York: United Nations."},{"key":"e_1_3_1_10_1","first-page":"30","volume-title":"Communicating Radiation Risks in Paediatric Imaging: Chapter 2: Radiation Protection Concepts and Principles","author":"WHO","year":"2017","unstructured":"WHO. 2017. Communicating Radiation Risks in Paediatric Imaging: Chapter 2: Radiation Protection Concepts and Principles. World Health Organization, Geneva. pp. 30\u201348."}],"container-title":["Annals of the ICRP"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01466453251412501","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01466453251412501","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01466453251412501","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:20:57Z","timestamp":1779124857000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01466453251412501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":9,"alternative-id":["10.1177\/01466453251412501"],"URL":"https:\/\/doi.org\/10.1177\/01466453251412501","relation":{},"ISSN":["0146-6453","1872-969X"],"issn-type":[{"value":"0146-6453","type":"print"},{"value":"1872-969X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"01466453251412501"}}