- Handbook on the Physics of Diagnostic Radiology, 2014 (IAEA)
- Dosimetry in Diagnostic Radiology for Paediatric Patients, Human Health Series No. 24, 2013 (IAEA)
- Code of Practice for Dosimetry in Diagnostic Radiology, Technical Report Series No. 457, 2007 (IAEA)
- Implementation of the International Code of Practice on Dosimetry in Diagnostic Radiology, 2011 (IAEA)
- Mettler F.A.Jr, Huda W., Yoshizumi T.T., Mahesh M., Effective Doses in Radiology and Diagnostic Nuclear Medicine: A Catalog, RSNA, 248:1 (2008)
- Chapple C-L. et al, Results of a survey of doses to paediatric patients undergoing common radiological examinations, Br J Radiol 65, 771 (1992) 225
- Billinger J. at al., Diagnostic reference levels in pediatric radiology in Austria, Eur Radiol 20 7 (2010) 1572
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Paediatric doses are more critical than adult doses since the patients are more sensitive to radiocarcinogenesis due their rapidly dividing cells and often have multiple examinations, especially in their early years of life. In addition, paediatric patients have a long life expectancy thereby providing a extended time for radiation induced cancers to be expressed. Consequently, radiation doses to paediatric should be closely monitored and optimized.
As noted above, paediatric patients have an increased susceptibility to radiocarcinogenesis. In addition, because of the body size, the internal organ doses may be proportionally higher than for larger patients. This is especially true for CT as the dose distribution throughout the body of a 5 year-old patient is relatively uniform and close to the entrance skin dose, compared to the adult where the internal dose may be two to four times less than the skin dose.
All of the principles discussed in Dose Audits apply to paediatric patients. However, dosimetry for paediatric patients is more difficult due to the size range of patients, e.g., from a few kilograms to 100 kilograms or more. Paediatric age groupings are often used to simply dosimetry for a large number of patients. However, this introduces increased uncertainty into the dose estimations.
Unfortunately, there is a paucity of published data on paediatric doses and reference levels. There is recent literature, some in preparation, available with references provided.
Introduction to References
There is a number of scientific studies in the field of paediatric dosimetry. The references included in the essential and supplemental references is just a small indicative fraction that can be helpful relative to paediatric reference levels.