New articles published: V. 14 n. 4 (2026)

Optimization of pediatric computed tomography protocols: dose reduction without loss of image quality

Abstract: This study aimed to optimize pediatric computed tomography (CT) protocols for abdomen and chest examinations, focusing on reducing radiation dose without compromising diagnostic image quality. Information was collected from factory protocols, current-modulated protocols, and those used in the routine of a university hospital, covering different age groups and acquisition parameters. The analyses included the evaluation of image quality metrics such as Signal-to-Noise Ratio (SNR), Contrast-to-Noise Ratio (CNR), Modulation Transfer Function (MTF50% and MTF10%), as well as dose indices (CTDIvol and DLP). Measurements were carried out using an ATOM 007/007TE anthropomorphic phantom, instead of a wire phantom, in accordance with international recommendations that recognize the applicability of different methods for determining MTF. Optimized protocols were proposed and tested. The data demonstrated that the suggested protocols allow significant dose reductions compared to the original protocols while maintaining adequate image quality levels. The comparison between factory, clinical routine, and optimized protocols highlighted the importance of adapting technical parameters to the pediatric profile and the available equipment, reinforcing the need for radioprotection practices aligned with the principles of justification and optimization. The results contribute to the development of safer and more effective guidelines in the context of pediatric CT, promoting highly accurate diagnoses with the lowest dose reasonably achievable, in accordance with the ALARA principle. Read full article.