Year: 2025 | Month: December | Volume: 12 | Issue: 12 | Pages: 844-853
DOI: https://doi.org/10.52403/ijrr.20251285
Dose Reduction Potential in Pediatric Chest CT: Comparative Analysis of Tube Voltage and Patient Protocol Presets Using a Custom Pediatric Chest Phantom
Muhammad Ghulam Raihan1, Jatmiko Endro Suseno1, Asep Yoyo Wardaya1, Heri Sutanto1
1Department of Physics, Faculty of Sciences and Mathematics, Diponegoro University, Semarang 50275, Indonesia
Corresponding Author: Muhammad Ghulam Raihan
ABSTRACT
Computed Tomography (CT) contributes significantly to medical radiation exposure, demanding rigorous dose optimization, especially for the radiosensitive pediatric population, yet high dose variability often results from inappropriate protocol selection. To address this, a custom-developed pediatric chest phantom, radiologically representative of a 7-year-old child, was utilized to systematically quantify dose impacts. The phantom was scanned using a Toshiba Aquilion Prime CT scanner across two protocol presets (adult chest and pediatric chest) at three tube voltage settings (80, 100, and 120 kV), with the pediatric protocol engaging the Automated Exposure Control (AEC). Dose metrics, including Volume CT Dose Index (CTDIvol) and Size-Specific Dose Estimate (SSDE), were calculated via the validated IndoseCT platform. The results demonstrated that the adult protocol consistently yielded SSDE values that were approximately 3.0 to 3.4 times greater than the pediatric protocol across all kV levels. Specifically, raising the tube voltage in the adult protocol caused a sharp rise in SSDE (from 2.10 mGy at 80 kV to 5.81 mGy at 120 kV). In contrast, the pediatric protocol maintained a highly stable SSDE (ranging from 1.52 mGy to 1.73 mGy) due to effective AEC compensation. In conclusion, the use of inappropriate adult presets for pediatric CT introduces a substantial and avoidable radiation dose penalty, potentially leading to doses that exceed established Diagnostic Reference Levels (DRLs). This study reinforces the critical necessity of strict adherence to size- and age-specific protocols and optimal AEC engagement as the primary strategy for achieving significant dose reduction in pediatric CT imaging.
Keywords: Pediatric CT, Dose Reduction, SSDE, Tube Voltage, Protocol Optimization, Pediatric Phantom
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