- Handbook on the Physics of Diagnostic Radiology, (IAEA - in preparation)
- Code of Practice for Dosimetry in Diagnostic Radiology (IAEA)
- Paediatric Doses from Fluoroscopy in the U.K. - Fee
- Paediatric Doses from Radiography in the U.K. - Fee
- Paediatric Doses from Radiography in Austria
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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 4.1 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 limited amount of literature specific to pediatric dosimetry. However, both of the IAEA publications are pertinent to the topic. Likewise, there is a paucity of national studies on pediatric dosimetry. The references on this topic in both the Essential and Supplemental References will be helpful relative to pediatric reference levels.