Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction: clinical article

J Neurosurg Pediatr. 2013 Oct;12(4):406-10. doi: 10.3171/2013.7.PEDS12631. Epub 2013 Aug 23.


Object: In this study, the authors describe their experience with a low-dose head CT protocol for a preselected neurosurgical population at a dedicated pediatric hospital (Seattle Children's Hospital), the largest number of patients with this protocol reported to date.

Methods: All low-dose head CT scans between October 2011 and November 2012 were reviewed. Two different low-dose radiation dosages were used, at one-half or one-quarter the dose of a standard head CT scan, based on patient characteristics agreed upon by the neurosurgery and radiology departments. Patient information was also recorded, including diagnosis and indication for CT scan.

Results: Six hundred twenty-four low-dose head CT procedures were performed within the 12-month study period. Although indications for the CT scans varied, the most common reason was to evaluate the ventricles and catheter placement in hydrocephalic patients with shunts (70%), followed by postoperative craniosynostosis imaging (12%). These scans provided adequate diagnostic imaging, and no patient required a follow-up full-dose CT scan as a result of poor image quality on a low-dose CT scan. Overall physician comfort and satisfaction with interpretation of the images was high. An additional 2150 full-dose head CT scans were performed during the same 12-month time period, making the total number of CT scans 2774. This value compares to 3730 full-dose head CT scans obtained during the year prior to the study when low-dose CT and rapid-sequence MRI was not a reliable option at Seattle Children's Hospital. Thus, over a 1-year period, 22% of the total CT scans were able to be converted to low-dose scans, and full-dose CT scans were able to be reduced by 42%.

Conclusions: The implementation of a low-dose head CT protocol substantially reduced the amount of ionizing radiation exposure in a preselected population of pediatric neurosurgical patients. Image quality and diagnostic utility were not significantly compromised.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Electromagnetic Radiation
  • Female
  • Head / diagnostic imaging*
  • Humans
  • Male
  • Oregon
  • Pediatrics / standards*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends*
  • Radiation Dosage
  • Risk Reduction Behavior
  • Tomography, X-Ray Computed / adverse effects
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / standards
  • Tomography, X-Ray Computed / statistics & numerical data*
  • Tomography, X-Ray Computed / trends