Pediatric Radiology

, Volume 43, Issue 9, pp 1128–1135 | Cite as

Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States

  • Katharine L. HopkinsEmail author
  • David R. Pettersson
  • Caroline W. Koudelka
  • Kristopher Spinning
  • Petra L. Vajtai
  • Brooke R. Beckett
  • Dianna M. E. Bardo
Original Article



During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients.


This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children’s hospital that tailors CT protocols to patient size as advocated by Image Gently.

Materials and methods

We compared 164 pediatric body scans done at community facilities (group X) with 466 children’s hospital scans. Children’s hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDIvol). SSDE was calculated and differences among groups were compared by regression analysis.


Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs.


Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged.


Computed tomography Radiation dose reduction Community hospitals Children’s hospitals Pediatrics 



The authors thank David P. Hopkins, MD, MPH, for invaluable assistance with study design and manuscript review.

Conflict of interest

K.L.H. reports unrelated research funding from GE Medical Systems (1995) and Toshiba Medical Systems (1997), D.R.P. was a speaker from Philips Healthcare (2011), and D.M.E.B. is a consultant and member of the Speaker’s Bureau for Koninklijke Philips Electronics NV.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Katharine L. Hopkins
    • 1
    • 2
    Email author
  • David R. Pettersson
    • 1
  • Caroline W. Koudelka
    • 3
  • Kristopher Spinning
    • 1
  • Petra L. Vajtai
    • 1
    • 2
  • Brooke R. Beckett
    • 1
  • Dianna M. E. Bardo
    • 1
    • 4
  1. 1.Department of Diagnostic Radiology, DC7ROregon Health & Science UniversityPortlandUSA
  2. 2.Department of PediatricsOregon Health & Science UniversityPortlandUSA
  3. 3.Division of Biostatistics, Department of Public Health & Preventive MedicineOregon Health & Science UniversityPortlandUSA
  4. 4.Department of Cardiovascular MedicineOregon Health & Science UniversityPortlandUSA

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