Article Details

Abstract Background: A manual Radiation Dose Management System (RDMS) was developed and utilised to monitor brain Computed Tomography (CT) doses in our facility. The results provided comprehensive dose records and identified high-dose procedures, particularly in paediatrics. This led to optimisation of paediatric protocols and ongoing prospective CT dose monitoring using RDMS to assess the impact of dose monitoring and optimisation in medical imaging. Methods: A prospective study was conducted for five months on paediatric patients referred for brain CT. Paediatric protocols were optimised based on kV and mAs and tested using the Quality Assurance (QA) phantom before being applied to patients. Prospective dose monitoring was performed using a manual RDMS. Local Diagnostic Reference Levels (LDRLs) were re-established and compared with national and international Diagnostic Reference Levels (DRLs). The data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. Results: A total of 114 paediatric patients who presented for brain CT were prospectively monitored. The sample was grouped as follows: <1 yr: 29; 1-<5 yr: 27; 5-<10 yr: 27; 10-<15 yr: 33. Dose reduction was observed in all the paediatric age groups, with the highest reduction of 34.5% in CTDIvol and 23.7% in DLP for the 5-<10 yr group. High doses above the DLP notification values were identified in <1 yr: 1, and 10-<15 yr: 2. Re-established local brain DRLs in CTDIvol were lower than national and international DRLs. Conclusion: The study has demonstrated the impact of dose monitoring using RDMS, with noted dose reduction following optimisation while maintaining diagnostic image quality. High DLP procedures were still noted; therefore, continuous dose monitoring is necessary for dose optimisation.