ArticleJapanese journal of radiology2025
Double low protocol in pediatric abdominal CT for evaluating right lower quadrant pain.
Article in Japanese journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The relationship between the diagnostic performance of dual-energy CT quantitative parameters in thyroid cancer, cervical lymph node metastasis and prognosis.BMC endocrine disorders · 2026Article
- Overuse of abdominopelvic CT in pediatric emergencies: a large single-center study from a middle eastern tertiary hospital.European journal of pediatrics · 2026Article
- Effects of Computed Tomography Technical Parameters on Body-Composition Analysis.Korean journal of radiology · 2025Review
- Current status and solutions for the overuse of emergency CT in pediatric patients with abdominal pain.Frontiers in pediatrics · 2025Review
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Authors and funding
3 authors.
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Abstract
purposeIn pediatric patients, minimizing radiation and contrast media exposure without compromising diagnostic accuracy is paramount. Double low protocol, which utilizes a low dose contrast concentration and low tube voltage, could be a safer alternative. We compare diagnostic efficacy of double low protocol (Group A, 240 mgI/ml + 80 kVp) with conventional protocol (Group B, 350 mgI/ml + 120 kVp) in pediatric patients (< 10 years) presenting with abdominal pain and suspected acute appendicitis. MATERIALS AND
methodsThis retrospective study included 121 pediatric patients who underwent enhanced abdominal CT between January 2019 and February 2023: 62 with Group A and 59 with Group B. We compared radiation dose, iodine load, and quantitative image quality parameters. Two radiologists independently assessed diagnostic image quality on a 5-point scale, visualization of the appendix, and diagnostic performance for acute appendicitis and its complications.
resultsThere were no significant differences in mean age (7.6 ± 2.0 vs. 7.6 ± 2.1, p = 0.956), body weight (31.4 ± 11.2 kg vs. 31.7 ± 11.4 kg, p = 0.972), and contrast media volume used (59.3 ± 21.0 ml vs. 65.0 ± 20.0 ml, p = 135) between the two groups. However, effective dose and iodine load used were significantly lower in Group A compared to Group B (2.7 ± 1.1 mSv vs. 4.3 ± 1.5 mSv and vs. 12.7 ± 4.6gI vs.18.6 ± 6.7gI, all p < 0.001). Although diagnostic image quality, noise and signal-to-noise ratio were significantly lower in Group A, visualization of the appendix (p = 0.853) and diagnostic accuracy for appendicitis were comparable between the two groups (98.4% vs. 94.9%, p = 0.284). DISCUSSION: The double low protocol offers an effective alternative for evaluating pediatric patients requiring enhanced abdomen CT, achieving comparable diagnostic performance while significantly reducing radiation dose. We believe that our findings support safer CT acquisition practices for pediatric patients requiring enhanced CT imaging.
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