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Computed tomography in paediatric patients: new strategies for radiation dose and image quality optimization

Grant number: 21/10117-9
Support Opportunities:Regular Research Grants
Duration: May 01, 2022 - April 30, 2024
Field of knowledge:Interdisciplinary Subjects
Principal Investigator:Marcelo Baptista de Freitas
Grantee:Marcelo Baptista de Freitas
Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
Associated researchers: Anna Luiza Metidieri Cruz Malthez ; Danielle Filipov Pereira ; Hugo Reuters Schelin ; Regina Bitelli Medeiros ; Roseli Kunzel

Abstract

Despite the benefits from radiological examinations, the ionization properties of x-rays do not allow them to be performed without any risk to the patient´s health. Specifically, in the cases of paediatric patients, its higher sensitivity to radiation associated with their longer life expectancy increases the risk of the appearance of harmful effects. With this in mind, the main purpose of the proposal is to support the study and implementation in the clinical routine of new strategies for optimization of radiation doses and image quality in computed tomography (CT) of paediatric patients. Computational tools, such as dose tracking software, for monitoring and managing dose indicators in CT will be implemented in the health institutions participating in the study. New dose indicators (SSDE and Dw) will be evaluated to improve estimates of radiation received by pediatric patients. Tomographic image quality will be evaluated using physical metrics (SNR, NEQ, MTF, NPS, among others) and clinically task-based approaches (ROC and/or VGA), including mathematical model observers that take into account iterative reconstruction techniques. Once the optimized protocols are established in all institutions participating in the study, diagnostic reference levels (DRLs) will be determined for paediatric patients of different age ranges (different biotypes) and different justifications or diagnostic hypotheses for the CT scan. The proposal involves researchers from the São Paulo and Paraná States, and will be carried out at the largest exclusively pediatric hospital in Brazil, located in the city of Curitiba, and in general hospitals at the metropolitan region of São Paulo. The outcomes from this proposal should strongly impact the quality of diagnostic imaging services, particularly CT scans, provide to children and young people seen in these institutions and, more generally, in all health services in the country that serve this group of patients. (AU)

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