Computed Tomography Diagnostic Reference Levels for Routine Pediatric Examinations in Saudi Arabia: A Systematic Review.

This work aims to review the diagnostic reference levels reported for pediatric patients who underwent routine CT exams in Saudi Arabia. The literature search was conducted in prominent search engines, including PubMed, Science Direct, Google Scholar, EBSCO, ProQuest, and Saudi Digital Library (SDL), which serve as important sources in the fields of radiology, radiography, and medical physics. The search was conducted to identify previous studies that have reported diagnostic reference levels (DRLs) for pediatric CT examinations. Only studies that specifically assessed DRLs in pediatric patients were considered for inclusion. On careful evaluation, eight publications were ultimately chosen out of the 31 that were originally considered. An assessment was made on the volume computed tomographic dose index (CTDIvol) and the dose-length product (DLP) values. The reported range of mean values for DLP (mGy.cm) included in this review for brain, chest, abdomen, abdomen and pelvis, and CAP (chest, abdomen, and pelvis) was 172-1881, 27.3-458.9, 94.5-790.1, 78-236, and 94.2, respectively. Moreover, the reported range of mean values for CTDIvol (mGy) included in this review for the brain, chest, abdomen, abdomen and pelvis, and CAP were 11.7-79.9, 1.2-20.1, 7.4-22.6, 2.6-5.5, and 3.6, respectively. The review emphasizes the need for standardized imaging protocols and DRLs in pediatric CT examinations to optimize radiation doses and patient safety. It recommends the development of annually reviewed comprehensive national DRLs in Saudi Arabia and improved training for technologists and physicians involved in pediatric CT imaging.