Diagnostic reference levels based on clinical indications for paediatric computed tomography examinations at the Mohammed VI University Hospital Center in Marrakech-Morocco

The study aims to derive the diagnostic reference levels for children based on clinical indications (DRL CI) in the computed tomography (CT) unit of the mother and child hospital (MCH) at the Mohammed VI University Hospital Centre in Marrakech (Med VI UHC-M). We retrospectively collected dosimetric statistics from 1730 CTs of children across three age groups (1–5 years, 5–10 years, and 10–15 years). Head, chest, abdomen-pelvis, and chest-abdomen-pelvis (CAP) CTs were the examinations studied. We have established 14 distinct clinical indications. For each indication, DRLs were defined as the median and third quartile values of the dose index CTDI vol and dose-length product DLP distributions. We analysed the calculated dose distributions between indications for each age group, using a non-parametric test to assess differences in DRLs. Statistical significance was defined at p < 0.01. We also compared our DRL CI with the published international standards. For head CT, the variability of CTDI vol and DLP was statistically significant between indications ( p < 0.01). However, for chest, abdomen-pelvis, and CAP CTs, the difference was significant for CTDI vol ( p < 0.01) and not significant for DLP ( p > 0.01). DRL CI in terms of CTDI vol are in good agreement with the literature. The DRLs for the head trauma indication were lower than the results from Europe and Africa, but for the other indications, the DRLs CI were higher than the results from Europe and lower than the ones of Africa.