{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:56:13Z","timestamp":1777434973818,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"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":["Acta Radiologica Open"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Pediatric patients are particularly vulnerable to the stochastic effects of ionizing radiation. Despite these risks, CT remains diagnostically essential in pediatric care. Diagnostic reference levels (DRLs) have been recommended as a radiation dose optimization tool to address these concerns.\n                    <jats:bold>Purpose:<\/jats:bold>\n                    This study aims to survey pediatric CT practices at different facilities in Australia, Canada, and Norway and to suggest local DRLs (LDRLs) at each facility as a baseline for future surveys.\n                    <jats:bold>Materials and methods:<\/jats:bold>\n                    Radiation dose indices, imaging, and demographic data were collected retrospectively at each facility using PACS for unenhanced CT head, contrast-enhanced chest, and contrast-enhanced abdomen-pelvis examinations in patients from 0 to 15\u00a0years of age. The LDRL values were determined for CT dose indices and size-specific dose estimate (SSDE) values. The Kruskal\u2013Wallis test assessed the equality of populations across countries for all dosimetric quantities. Ordinary least squares regression was employed to express SSDE as a linear function of patient weight.\n                    <jats:bold>Results:<\/jats:bold>\n                    The LDRLs for Australian, Canadian, and Norwegian facilities were determined and examined for each age group. Canadian and Norwegian LDRL data were most similar, with Australian values being comparatively lower for all categories except for 11\u201315-year-old abdomen-pelvis examinations. The SSDE and patient weight were significantly positively correlated for each examination\/country combination.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The proposed local reference levels can provide local baselines for dose optimization and continuous dose assessment.\n                  <\/jats:p>","DOI":"10.1177\/20584601251340974","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T15:32:09Z","timestamp":1747063929000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A multi-institutional CT practices survey of pediatric head, chest, and abdomen-pelvis examinations"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-5534","authenticated-orcid":false,"given":"Elena","family":"Tonkopi","sequence":"first","affiliation":[{"name":"Dalhousie University"},{"name":"Dalhousie University"},{"name":"Nova Scotia Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Iwaskow","sequence":"additional","affiliation":[{"name":"Dalhousie University"},{"name":"IWK Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilie Karlstad","family":"L\u00f8nningen","sequence":"additional","affiliation":[{"name":"Oslo Metropolitan University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex Myrvold","family":"Johansen","sequence":"additional","affiliation":[{"name":"Oslo Metropolitan University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivethan","family":"Suganthan","sequence":"additional","affiliation":[{"name":"Oslo Metropolitan University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulia","family":"Kotlyarova","sequence":"additional","affiliation":[{"name":"Dalhousie University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Badawy","sequence":"additional","affiliation":[{"name":"Monash Health Imaging"},{"name":", Monash Health"},{"name":"Monash University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Gunn","sequence":"additional","affiliation":[{"name":"Dalhousie University"},{"name":"Dalhousie University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Kimber","sequence":"additional","affiliation":[{"name":"Nova Scotia Health"},{"name":"IWK Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Jackson","sequence":"additional","affiliation":[{"name":"Monash Health Imaging"},{"name":", Monash Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercy Afadzi","family":"Tetteh","sequence":"additional","affiliation":[{"name":"Akershus University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja Oestgaard","family":"Holter","sequence":"additional","affiliation":[{"name":"Oslo University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2307-4179","authenticated-orcid":false,"given":"Safora","family":"Johansen","sequence":"additional","affiliation":[{"name":"Oslo Metropolitan University"},{"name":"Oslo University Hospital"},{"name":"Singapore Institute of Technology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.JCRT_945_20"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0146645317717209"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02620-0"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0743-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13111057"},{"key":"e_1_3_3_7_2","unstructured":"European Commission Directorate-General for Energy. European guidelines on diagnostic reference levels for paediatric imaging. Publications Office 2018. https:\/\/data.europa.eu\/doi\/10.2833\/486256 (Accessed 22 April 2024)."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmir.2021.12.005"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radmp.2021.02.001"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncz056"},{"key":"e_1_3_3_11_2","first-page":"1823","article-title":"An audit of radiation doses received by paediatric patients undergoing computed tomography investigations at academic hospitals in South Africa","volume":"24","author":"van der Merwe CM","year":"2020","unstructured":"van der Merwe CM, Mahomed N. An audit of radiation doses received by paediatric patients undergoing computed tomography investigations at academic hospitals in South Africa. SA J Radiol 2020; 24: 1823\u20131828.","journal-title":"SA J Radiol"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021219027"},{"key":"e_1_3_3_13_2","unstructured":"American Association of Physicists in Medicine (AAPM). Size-specific dose estimates (SSDE) in pediatric and adult body CT examinations. Task Group No. 204 2011. https:\/\/www.aapm.org\/pubs\/reports\/rpt_204.pdf (Accessed 22 April 2024)."},{"key":"e_1_3_3_14_2","unstructured":"Australian Radiation Protection and Nuclear Safety Agency. Current Australian national diagnostic reference levels for multi detector computed tomography. https:\/\/www.arpansa.gov.au\/research-and-expertise\/surveys\/national-diagnostic-reference-level-service\/current-australian-drls\/mdct (n.d.) Accessed 22 April 2024."},{"key":"e_1_3_3_15_2","unstructured":"Health Canada. Canadian computed tomography survey: national diagnostic reference levels. Published June 14 2016. https:\/\/www.canada.ca\/en\/health-canada\/services\/publications\/health-risks-safety\/canadian-computed-tomography-survey-national-diagnostic-reference-levels.html Accessed 22 April 2024."},{"key":"e_1_3_3_16_2","unstructured":"Widmark A Heimland N. Diagnostic reference doses and dose-weight curves for paediatric X-ray examinations: results from a nordic project. \u00d8ster\u00e5s: Norwegian radiation and nuclear safety authority DSA Report 2022. 06. Available at. https:\/\/dsa.no\/publikasjoner\/_\/attachment\/inline\/cc58c7bb-62af-4dd4-94c6-9817fa0e1d40:db5bf247dfefe8197cf3b320ab3a0bd164835521\/DSA-rapport-06-2022-DRL-pediatri.pdf Accessed 22 April 2024."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1501500117"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212801"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.12191"},{"key":"e_1_3_3_20_2","first-page":"58","article-title":"Size specific dose estimate (SSDE) for estimating patient dose from CT used in myocardial perfusion SPECT\/CT","volume":"8","author":"Rajaraman V","year":"2020","unstructured":"Rajaraman V, Ponnusamy M, Halanaik D. Size specific dose estimate (SSDE) for estimating patient dose from CT used in myocardial perfusion SPECT\/CT. 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