Establishing Pediatric Thoracic Radiography Diagnostic Reference Levels Using CALDOSE_X: A Data-Driven Approach to Optimize Radiation Safety

Ikbal  Bouadel; Morad El  Kafhali; Marziyeh  Tahmasbi; Soukaina  Mefrah; Rajaa  Sebihi

doi:10.18502/fbt.v13i1.20788

Ikbal Bouadel High Energy Physics Laboratory Modeling and Simulation (HEPL-MS), Faculty of Sciences, Department of Physics, Mohammed V University, Rabat, Morocco
Morad El Kafhali Physical Sciences and Engineering, Innovative Research and Applied Physics (IRAP), Faculty of Sciences, Moulay Ismail University, Meknes, Morocco
Marziyeh Tahmasbi Department of Radiology Technology, School of Allied Medical Sciences Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Soukaina Mefrah High Energy Physics Laboratory Modeling and Simulation (HEPL-MS), Faculty of Sciences, Department of Physics, Mohammed V University, Rabat, Morocco
Rajaa Sebihi High Energy Physics Laboratory Modeling and Simulation (HEPL-MS), Faculty of Sciences, Department of Physics, Mohammed V University, Rabat, Morocco

DOI: https://doi.org/10.18502/fbt.v13i1.20788

Keywords: Pediatrics Thoracic Radiography; Diagnostic Reference Levels; CALDOSE_X; Radiation Safety.

Abstract

Purpose: Disparities exist in adherence to national radiation safety standards in Morocco, particularly in pediatric conventional radiology. This cross-sectional study aims to establish Moroccan diagnostic reference levels (DRLs) for pediatric thorax radiography.

Materials and Methods: Thorax radiographs of 208 pediatric patients (newborns to 18 years old) from four Moroccan public hospitals were analyzed. Patient demographics (age, gender, weight) and scan parameters were recorded to calculate radiation doses using CALDOSE_X 5.0 software, focusing on entrance surface air kerma (ESAK, mGy) and kerma-area product (KAP, mGy·cm²). Patients were categorized into five age groups (<1 month, 1 month ≤ age < 4 years, 4 years ≤ age < 10 years, 10 years ≤ age < 14 years, and 14 years ≤ age < 18 years). The third quartile (P75) of ESAK and KAP were determined as DRLs. Statistical analyses were performed using SPSS v.21, with p < 0.05 indicating significance.

Results: The P75 values of ESAK and KAP across age groups were 0.61, 0.69, 0.68, 0.82, and 1.29 for ESAK and 350.25, 566.07, 499.14, 950.62, and 1816.06 for KAP. The regional DRLs exceeded those reported in some European countries, likely due to differences in imaging protocols, patient positioning, and exposure parameters. Additionally, irradiated surface area significantly influenced dose variation in patients under 10 years (p < 0.01).

Conclusion: Establishing Moroccan pediatric DRLs highlights the need for dose optimization in pediatric radiography. Optimizing irradiated surfaces and exposure parameters while ensuring adherence to international DRL recommendations is essential to enhance radiation safety in pediatric imaging.