Original Research - Special Collection: Paediatric Radiology

An audit of radiation doses received by paediatric patients undergoing computed tomography investigations at academic hospitals in South Africa

Cornelis M. van der Merwe, Nasreen Mahomed
South African Journal of Radiology | Vol 24, No 1 | a1823 | DOI: https://doi.org/10.4102/sajr.v24i1.1823 | © 2020 Cornelis M. van der Merwe, Nasreen Mahomed | This work is licensed under CC Attribution 4.0
Submitted: 13 November 2019 | Published: 16 October 2020

About the author(s)

Cornelis M. van der Merwe, Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Nasreen Mahomed, Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


Background: Diagnostic reference levels (DRLs) are a crucial element of auditing radiation doses in paediatric computed tomography (CT). Currently, there are no national paediatric CT DRLs in South Africa.

Objectives: The aim of this article was to establish local paediatric DRLs for CT examinations at two academic hospitals and to compare paediatric CT radiation output levels with established DRLs in the developed and developing world.

Method: Computed Tomography Dose Indexvolume (CTDIvol) and dose length product (DLP) values were collected from CT examinations performed at two university hospitals for patients aged 0–15 years, during 01 November 2016–30 April 2017. The 75th percentile of the data distribution was calculated for each CT examination type and age group, further categorised into routine working hours and after-hours for both hospitals and statistically compared.

Results: Of the 1031 CT examinations performed, CT brain examination was the most common (755/1031; 72.23%). DLP values were increased in the after-hours categories compared to regular working hours at both hospitals. The largest increase was in the 0–1 year age group (150.56%). With the exception of CT Chest and CT abdomen in the 0–1 year age group, the CTDIvol and DLP values compared favourably to international standards.

Conclusion: Most of the calculated DRLs are acceptable and internationally comparable. This likely indicates effective reduction techniques and protocols. Computed tomography body examination protocols for 0–1 year patients should be reviewed. Strategies should be implemented to limit higher doses in after-hours examinations.


Radiation dose; Computed tomography (CT); Paediatric patients; Diagnostic Reference Level (DRL); Computed Tomography Dose Indexvolume (CTDIvolume)


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