|ECR 2019 / C-2439|
|Diagnostic Reference Levels for Paediatric Radiographic Procedures in Ireland|
Aims and objectives
There are two dedicated paediatric hospitals in the Republic of Ireland, Our Lady’s Children’s Hospital Crumlin (OLCHC) and Temple Street Children’s University Hospital (TSCUH). In January 2019, TSCUH and OLCHC merged to become part of a new hospital group, Children’s Health Ireland (CHI). CHI is committed to ensuring that paediatric healthcare services in Ireland continue to develop in line with international best practice standards.
Part of this standard of care is to ensure patients undergoing X-ray examinations receive radiation doses as low as reasonably achievable (ALARA), while ensuring adequate image quality is maintained. To aid in this, both hospitals are required to establish local diagnostic reference levels (DRLs). DRLs are defined in Irish Legislation (SI 478 of 2002 ) as dose levels which “are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied”. These local DRLS can then be used as the benchmark for dose optimisation in paediatric radiology in Ireland. The recently published European RP 185  document provides guidelines for establishing local and national paediatric DRLs. It also published European DRLs for comparison purposes. While Ireland contributed to this publication, the data used for radiographic exams was based on an audit published in 2004. To account for the technological improvements in imaging over the past 14 years, a new audit of patient doses is required.
OLCHC have established their local DRLs for general X-ray examinations using Digital Radiography (DR) systems. Recently, one of the main X-ray rooms in TSCUH was upgraded from a Computed Radiography (CR) system, to a Digital Radiography system. As a result, TSCUH began collating examination data for general radiography examinations to establish DRLs for those examinations. To achieve this, the radiology team at TSCUH, in conjunction with Medical Physics, have liaised with colleagues at OLCHC, on the appropriate exposure parameters and clinical set-ups using a DR system. A dose audit was carried out after the system was in use for a period of one month. This work presents the results of the TSCUH audit and compares the results with the DRLs established in OLCHC. Results are also compared with those published in RP 185 .
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