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. 2025 Mar;72(1):139-147.
doi: 10.1002/jmrs.824. Epub 2024 Sep 12.

Paediatric computed tomography diagnostic reference levels in Africa: A systematic review

Emmanuel Gyan  1 , Christiana Subaar  2 , George Edusei  3 , Linda Antwi Nyarko  1
Affiliations

Paediatric computed tomography diagnostic reference levels in Africa: A systematic review

Emmanuel Gyan et al. J Med Radiat Sci. 2025 Mar.

Abstract

Introduction: Improvements in computed tomography (CT) technology in terms of image quality and reduction in absorbed dose have increased its applications in medical imaging. Diagnostic reference levels (DRLs) help to identify high radiation doses that are unusually delivered to patients undergoing exposure to ionising radiation. The aim of this review was to provide an overview of published studies by African researchers towards establishing paediatric CT DRLs in Africa.

Methods: The search for articles was conducted using some relevant literature search engines including PubMed, Scopus, Science Direct, Google Scholar and Web of Science. Two reviewers were involved in the article selection process which involved a three-stage screening process of identifying; article titles, abstracts and full-test reading.

Results: One hundred and seventy-four articles were identified from the database, PubMed (30), Scopus (21), Google Scholar (53), Web of Science (25) and Science Direct (45). Fifty duplicated articles were excluded before screening. Twelve peer-reviewed articles were included in this study based on the inclusion criteria. DRL values in terms of computed tomography dose index volume of head for the age groupings 0-1, 1-5, 5-10 and 10-15 were 27, 36.6, 39.5 and 47.5 mGy while the dose length product values were 461.6, 664, 872 and 978 mGy.cm respectively. The DRLs were calculated as 75th percentile of the local DRLs reported by the 12 articles included in this review.

Conclusion: This review has shown that only few of the African countries (19%) have published studies on paediatric CT DRLs. There were variations in the DRLs published by the various authors which indicate that harmonisation and standardisation of paediatric CT protocols is essential for the optimisation of paediatric doses.

Keywords: Computed; diagnostic; dose; paediatric; reference; tomography.

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Conflict of interest statement

The authors have no conflict of interest in this work.

Figures

Figure 1
Figure 1
PRISMA diagram for systematic review on paediatric CT DRLs in Africa.
See this image and copyright information in PMC

References

    1. Esser M, Hess S, Teufel M, et al. Radiation dose optimisation in paediatric chest CT. Major indicators of dose exposure in 1695 CT scans over seven years. Fortscher Rontgenstr 2018; 190: 1131–1140. - PubMed
    1. Al‐Rammah YT. CT radiation dose awareness among paediatricians. Italian J Paediatric 2016; 42: 77. - PMC - PubMed
    1. Abdulkadir MK, Rahim NAYM, Mazlan NS, Daud ND. Dose optimisation in paediatric CT examination: Assessment on current scanning protocols associated with radiation dose. Radiat Phys Chem 2020; 171: 2–6.
    1. Pearce M, Salloti J, Gonzalez A. CT scans in childhood and subsequent risk of leukemia and brain tumours: A retrospective cohort studies. Lancet 2012; 380: 499–505. - PMC - PubMed
    1. Thakur Y, Mclaughlin DP, Mayo JR. Strategies for radiation dose optimisation. Curr Radiol Rep 2013; 2013: 1–10.

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