How well Nigerian radiographers adhere to pediatrics-specific protocols during computed tomography procedures

Abstract

INTRODUCTION: Enormously high-dose procedures such as computed tomography requires pediatrics-specific protocols due to high tissue radio-sensitivity and higher lifetime attributable cancer risks. It’s not known if radiographers in Nigeria consider this fact at all times.
This work aimed to survey head computed tomography dose in Nigeria for evidence of pediatric- specific practice.

METHODS: The census of CT scanners was undertaken prospectively across the country from June 2019 to September 2021, while the dose survey was undertaken retrospectively in 14 facilities distributed evenly across the geopolitical zones between February to September 2021. Data on computed tomography installations were supplied by radiographers spread across the country. A dose survey involving 490 and 700 pediatrics and adult patients emanated from fourteen of those facilities. Doses were extracted from on-screen volumetric CT dose index (CTDIvol) and dose- length product (DLP) in non-contrast investigations.

RESULTS: There were 209 CT scanners installed in Nigeria as of September 2021, with a triennial growth rate of 12.4% (n = 26). Monthly patient throughput for all CT requests was ≤ 41,412 with pediatric cases accounting for 10.4 % (n = 4,311). Mean head dose for pediatrics and adults with CTDIvol (41/58 mGy) and DLP (922/1198 mGy-cm) appeared different prima facie. However, a paired - sample t-test gave statistically significant difference in the CTDIvol (p = 0.001), but not with DLP (p = 0.055).

CONCLUSION: The installation of CT scanners is on the increase in Nigeria. Pediatric and adult CT dose had minimal differences. Given the higher lifetime attributable cancer risks for pediatrics, this should be worrisome. This calls for pediatric- specific protocol design and enforcement by relevant regulatory agencies, as well as meticulous optimization of protection from radiation by radiation practitioners.