Evidence map›Paper›PMID 40515769›Full record

ArticleEuropean radiology2025

Diagnostic reference levels for indication-based CT categories in pediatric CT: data from an international registry.

Denise Bos, Yifei Wang, Carly Stewart, Philip W Chu, Jason Luong, Johannes Haubold, Benjamin Schröer, Sebastian Zensen, Phuong-Anh T Duong, Sebastian Schindera and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Denise BosInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany. denise.bos@uk-essen.de.ORCID http://orcid.org/0000-0002-9585-9787
Yifei WangDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Carly StewartDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Philip W ChuDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Jason LuongDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Johannes HauboldInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Benjamin SchröerFaculty of Medicine, University Duisburg-Essen, Essen, Germany.
Sebastian ZensenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Phuong-Anh T DuongDepartment of Radiology, NYU Grossman School of Medicine, New York, NY, USA.
Sebastian SchinderaInstitute of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.
Cécile R L P N JeukensDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Marco DasDepartment of Diagnostic and Interventional Radiology, Helios Rhein-Ruhr Kliniken GmbH, Duisburg, Germany.
Andrew J EinsteinSeymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, NY, USA.
Luisa CervantesDepartment of Radiology, Nicklaus Children's Hospital, Miami, FL, USA.
Rebecca Smith-BindmanInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.

Funding

CT DOSE CollaboratoryR01CA181191 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SMITH-BINDMAN, REBECCA · 2014 to 2019
$6.2M
Deutsche Forschungsgemeinschaft FU356/12-2NCI NIH HHS R01 CA181191Patient-Centered Outcomes Research Institute CD-1304-7043, DI-2018C1-11375US National Institutes of Health R01- CA181191
6 · The paper itself

Abstract

objectivesComputed tomography (CT) radiation doses vary depending on medical indications, protocols, and local practice. Our aim is to establish diagnostic reference levels (DRLs) for CT categories based on clinical indications in pediatric patients. MATERIALS AND

methodsWe analyzed CT data from an international dose registry retrospectively, including scans performed in children under 18 years at 143 facilities between January 2016 and January 2021. DRLs were calculated for volumetric CT dose index (CTDI

resultsA total of 95,047 CT scans (mean age, 10.4 ± 5.6 years, 54% male), including 41 different indications, were included. DRLs increased with increasing age group (p < 0.05 for trend). For the head and the abdomen/pelvis body regions, there was greater variation between the CT categories than between the indications within the categories, suggesting these categories are valid. For example, in 10- to 15-year-old children, the DRLs for the DLP increased from 362 mGy·cm for head low dose to 2058 mGy·cm for head high dose. The U.S. DRLs were similar to the European for head categories, but were around twice as high for routine dose chest, and abdomen/pelvis.

conclusionsWe have established DRLs for indication-based CT category age groups to help standardize practice. KEY POINTS: Question CT categories are needed to reflect body regions and clinical indications with similar radiation dose requirements in pediatric patients. Findings Doses varied more between CT categories than within. DRLs for chest and abdomen/pelvis were about twice as high in the U.S. as in Europe. Clinical relevance DRLs as a function of patient age were developed for 14 broad anatomy- and indication-based CT categories in children using registry data.

Indexed as

Radiation DosageTomography, X-Ray ComputedAdolescentChildChild, PreschoolDiagnostic Reference LevelsEuropeFemaleHumansInfantInfant, NewbornMaleRegistriesRetrospective StudiesUnited StatesDiagnostic imagingDiagnostic reference levelsPediatricsRegistriesTomography (X-ray computed)

Identifiers

PMID40515769
PMCPMC12634736

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.