Pediatric effective doses can be obtained for any radiologic examination using the selected radiographic technique factors (kV/mAs), the exposure geometry and the patient mass. The energy imparted ε to the patient may be computed from the exposure area product, x-ray tube voltage, half-value layer and patient thickness. Values of energy imparted may be subsequently converted to an effective dose E using published radiographic projection specific E/ε ratios determined using Monte Carlo techniques applied to anthropomorphic phantoms, with a correction applied for the patient mass. Pediatric effective doses (head, chest, abdomen and extremity) were computed for representative adult patients, as well as for pediatric patients ranging from new born to 15 year old youths. Values of patient effective dose were dependent on body size, selected technique factors as well as the type of radiographic imaging equipment used, with no clear trends for effective dose with patient age.

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Available from: Robert J Botash, Oct 24, 2014
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    ABSTRACT: Background Skeletal surveys for non-accidental trauma (NAT) include lateral spinal and pelvic views, which have a significant radiation dose. Objective To determine whether pelvic and lateral spinal radiographs should routinely be performed during initial bone surveys for suspected NAT. Materials and methods The radiology database was queried for the period May 2005 to May 2011 using CPT codes for skeletal surveys for suspected NAT. Studies performed for skeletal dysplasia and follow-up surveys were excluded. Initial skeletal surveys were reviewed to identify fractures present, including those identified only on lateral spinal and/or pelvic radiographs. Clinical information and MR imaging was reviewed for the single patient with vertebral compression deformities. Results Of the 530 children, 223 (42.1%) had rib and extremity fractures suspicious for NAT. No fractures were identified solely on pelvic radiographs. Only one child (<0.2%) had vertebral compression deformities identified on a lateral spinal radiograph. This infant had rib and extremity fractures and was clinically paraplegic. MR imaging confirmed the vertebral body fractures. Conclusion Since no fractures were identified solely on pelvic radiographs and on lateral spinal radiographs in children without evidence of NAT, nor in nearly all with evidence of NAT, inclusion of these views in the initial evaluation of children for suspected NAT may not be warranted.
    No preview · Article · Jan 2013 · Pediatric Radiology