A scoping review of radiation dose and image quality in paediatric CT: Towards safe imaging protocols and diagnostic reference levels in Jordan.
Authors
Affiliations (5)
Affiliations (5)
- School of Physics, Universiti Sains Malaysia, 11700 Gelugor, Penang, Malaysia; Diagnostic Radiology Department, Al-Bashir Hospital, Amman 11118, Jordan.
- School of Physics, Universiti Sains Malaysia, 11700 Gelugor, Penang, Malaysia. Electronic address: [email protected].
- Department of Medical Physics, College of Applied Sciences, University of Fallujah, Iraq.
- Faculty of Applied Medical Sciences, AL- Bayt University, P.O.Box 130040, Mafraq 25113, Jordan.
- Diagnostic Radiology Department, Al-Bashir Hospital, Amman 11118, Jordan.
Abstract
Computed tomography (CT) is an essential diagnostic tool, but its associated radiation exposure raises significant concerns, especially for radiosensitive paediatric populations. Diagnostic Reference Levels (DRLs) are vital for dose optimization, yet many regions, including Jordan, lack established national DRLs for children. This study systematically reviews international evidence on paediatric CT DRLs, assesses current radiation dose practices in Jordan, and offers evidence-based recommendations for establishing national DRLs and optimized imaging protocols. A systematic literature search was performed across PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2010 and 2024, following PRISMA guidelines. Studies reporting CT Dose Index volume (CTDIvol) and Dose-Length Product (DLP) for paediatric patients were included. Twenty-eight studies made up the final analysis, showing significant variations in radiation doses across different countries and institutions. Studies from Jordan indicated notably higher dose levels (e.g., head CT DLP up to 1400 mGy·cm) compared to European and other international standards. This difference is mainly due to the lack of standardized protocols and the limited use of advanced dose-reduction technologies. The review also emphasizes that modern reconstruction techniques, such as Deep Learning Reconstruction (DLIR), can lower radiation doses by 20-50% without sacrificing image quality. Jordan urgently needs to establish national, age- and size-specific paediatric DRLs. Implementing standardized protocols, investing in dose-reduction technologies, and encouraging ongoing education are crucial steps to align with international best practices and improve patient safety in paediatric CT imaging.