• Journal of radiological science and technology
• /
• v.33 no.4
• /
• pp.327-334
• /
• 2010

Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

• Journal of Chest Surgery
• /
• v.34 no.12
• /
• pp.964-967
• /
• 2001

Giant thymic Hyperplasia is a rare lesion in children. We report a case of giant thymic hyperplasia in the right anterior mediastinum in a 2 year-old male patient. Presenting symptom was frequent cough and sputum, plain chest X-ray and computed tomography showed huge mass in the right anterior mediastinum. The tumor resection was done through a median sternotomy for the prevention of progression to atelectasis caused by mass effect and tissue diagnosis. An open biopsy specimen showed normal thymic architecture. The patient recovered without any problem and is doing well untill now. We report this rare case of giant thymic hyperplasia with review of the literature.

• Clinical and Experimental Pediatrics
• /
• v.45 no.3
• /
• pp.339-345
• /
• 2002

Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.

• Journal of radiological science and technology
• /
• v.40 no.3
• /
• pp.355-361
• /
• 2017

Pediatrics are more sensibility to radiation than adults and because they are organs that are not completely grown, they have a life expectancy that can be adversely affected by exposure. Therefore, the management of exposure dose is more important than the case of adult. The purpose of this study was to determine the suitability of the 10 year old phantom for the 5 year old pediatric's recommendation and the incident surface dose, and to measure the organ absorbed dose. This study is compared the organ absorbed dose and the entrance surface dose in the clinical conditions at 5 and 10 years old pediatric. Clinical 5 year old condition was slightly higher than recommendation condition and 10 year old condition was very high. In addition, recommendation condition ESD was found to be 43% higher than the ESD of the 5 year old group and the ESD of the 10 year old group was 126% higher than that of the 5 year old group. The recommended ESD at 5 years old and the ESD according to clinical imaging conditions were 31.6%. There was no significant difference between the 5 year old recommended exposure conditions and the organ absorbed dose due to clinical exposure conditions, but there was a large difference between the Chest and Pelvic. However, it was found that there was a remarkable difference when comparing the organ absorbed dose by 10 year clinical exposure conditions. Therefore, more detailed standard exposure dose for the recommended dose of pediatric should be studied.

• Progress in Medical Physics
• /
• v.22 no.4
• /
• pp.163-171
• /
• 2011

The purpose of this study was to investigate the effect of various technical parameters for the dose optimization in pediatric chest radiological examinations by evaluating effective dose and effective detective quantum efficiency (eDQE) including the scatter radiation from the object, the blur caused by the focal spot, geometric magnification and detector characteristics. For the tube voltages ranging from 40 to 90 kVp in 10 kVp increments at the FDD of 100, 110, 120, 150, 180 cm, the eDQE was evaluated at the same effective dose. The results showed that the eDQE was largest at 60 kVp when compares the eDQE at different tube voltage. Especially, the eDQE was considerably higher without the use of an anti-scatter grid on equivalent effective dose. This indicates that the reducing the scatter radiation did not compensate for the loss of absorbed effective photons in the grid. When the grid is not used the eDQE increased with increasing FDD because of the greater effective modulation transfer function (eMTF). However, most of major hospitals in Korea employed a short FDD of 100 cm with an anti-scatter grid for the chest radiological examination of a 15 month old infant. As a result, the entrance surface air kerma (ESAK) values for the hospitals of this survey exceeded the Korean DRL (diagnostic reference level) of $100{\mu}Gy$. Therefore, appropriate technical parameters should be established to perform pediatric chest examinations on children of different ages. The results of this study may serve as a baseline to establish detailed reference level of pediatric dose for different ages.

• Journal of the Korean Society of Radiology
• /
• v.17 no.3
• /
• pp.297-303
• /
• 2023

Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.

• Journal of Radiation Protection and Research
• /
• v.28 no.1
• /
• pp.35-42
• /
• 2003

Methodology for calculating the organ equivalent doses and the effective doses of pediatric and adult patients undergoing medical X-ray examinations were established. The MIRD-type mathematical phantoms of 4 age groups were constructed with addition of the esophagus to the same phantoms. Two typical examination procedures, chest PA and abdomen AP, were simulated for the pediatric patients as well as the adult as illustrative examples. The results confirmed that patients pick up approximate 0.03 mSv of effective dose from a single chest PA examination, and 0.4 to 1.7 mSv from an abdomen AP examination depending on the ages. For dose calculations where irradiation is made with a limited field, the details of the position, size and shape of the organs and the organ depth from the entrance surface considerably affect the resulting doses. Therefore, it is important to optimize radiation protection by control of X-ray properties and beam examination field. The calculation result, provided in this study, can be used to implement optimization for medical radiation protection.

• Pediatric Infection and Vaccine
• /
• v.31 no.1
• /
• pp.75-82
• /
• 2024

Purpose: As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022. This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city. Methods: In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed. Results: A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics. Conclusions: This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.

• Journal of Radiation Protection and Research
• /
• v.40 no.2
• /
• pp.118-123
• /
• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

• Clinical and Experimental Pediatrics
• /
• v.51 no.10
• /
• pp.1123-1126
• /
• 2008

A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8-month-old male infant, who was born at 35 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.