Abstract The widespread use of computed tomography (CT) has led researchers to study CT dose exposure associated with carcinogenic effects, especially in pediatric populations. The number of pediatric patients undergoing CT scans increases every year and there is a wide range of exposure doses from the examination. In this study, we carried out systematic reviews and meta-analysis study on radiation dose received by paediatric patients during CT thorax, CT abdomen, CT abdomen-pelvis and CT thorax-abdomen-pelvis (TAP) examinations. Furthermore, the relationship between the radiation dose and the associated factors, such as scanning protocols, CT parameters, and body weight inclusive of the image quality produced was investigated. Four different databases, namely PubMed, Ovid MEDLINE, ScienceDirect, and Scopus have been used to get eligible studies published from 2010 to 2019. A total of 95 articles related to CT thorax, abdomen, and/or pelvis for paediatric patients are collected. After the final screening process, 38 articles are included in the study where 19, 8, 6 and 5 articles involving CT thorax, CT abdomen, CT abdomen-pelvis, and CT TAP examinations, respectively. Dose data, volume-weighted CT dose index (CTDIvol), dose length product (DLP), effective dose (E) and size-specific dose estimates (SSDE) are extracted in each selected studies. The highest value of mean CTDIvol, DLP, E and SSDE is found in CT abdomen-pelvis with the weight-based protocol for a patient with > 40 kg are 9.1 ± 1.2 mGy, 440.7 ± 0.0 mGy cm, 10.0 ± 0.0 mSv, and 13.7 ± 1.9 mGy respectively. We conducted a meta-analysis of selected cohort studies to explore the association between paediatric dose and region of examination which categorized based on weight. There is no difference found in CTDIvol between the group of CT thorax, CT abdomen-pelvis and CT TAP with It is established that the application of size or weight - base protocol with the adjustment of CT acquisition parameter and used of iterative reconstruction technique could substantially reduce the radiation dose while maintaining the image quality.

中文翻译：

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儿童人群中胸部-腹部-骨盆区域计算机断层扫描辐射剂量暴露的系统评价和荟萃分析

摘要 计算机断层扫描 (CT) 的广泛使用促使研究人员研究与致癌作用相关的 CT 剂量暴露，尤其是在儿科人群中。接受 CT 扫描的儿科患者数量逐年增加，并且检查中的暴露剂量范围很广。在本研究中，我们对儿科患者在 CT 胸部、CT 腹部、CT 腹盆和 CT 胸腹盆 (TAP) 检查期间接受的辐射剂量进行了系统评价和荟萃分析研究。此外，研究了辐射剂量与相关因素（例如扫描协议、CT 参数和体重（包括所产生的图像质量））之间的关系。四个不同的数据库，即 PubMed、Ovid MEDLINE、ScienceDirect、和 Scopus 已被用于获得 2010 年至 2019 年发表的符合条件的研究。 共收集了 95 篇与儿科患者的胸部、腹部和/或骨盆 CT 相关的文章。经过最后的筛选过程，38篇文章被纳入研究，其中19篇、8篇、6篇和5篇分别涉及CT胸部、CT腹部、CT腹盆和CT TAP检查。在每个选定的研究中提取剂量数据、体积加权 CT 剂量指数 (CTDIvol)、剂量长度乘积 (DLP)、有效剂量 (E) 和大小特异性剂量估计 (SSDE)。平均 CTDIvol、DLP、E 和 SSDE 的最高值在 CT 腹部 - 骨盆中发现，对于大于 40 kg 的患者，基于体重的协议为 9.1 ± 1.2 mGy、440.7 ± 0.0 mGy cm、10.0 ± 0.0 mSv 和分别为 13.7 ± 1.9 mGy。我们对选定的队列研究进行了荟萃分析，以探讨儿科剂量与根据体重分类的检查区域之间的关联。CT 胸部、CT 腹盆和 CT TAP 组在 CTDIvol 中没有发现差异 确定应用尺寸或体重-基础协议并调整 CT 采集参数和使用迭代重建技术可以显着减少辐射剂量，同时保持图像质量。