Patient-based Performance Assessment for Pediatric Abdominal CT: An Automated Monitoring System Based on Lesion Detectability and Radiation Dose

Rationale and Objective To deploy an automated tool for evaluating pediatric body computed tomography (CT) performance utilizing metrics of radiation dose and image quality for the task of liver lesion detection. Materials and Methods This IRB approved retrospective investigation used 507 IV-contrast-enhanced abdominopelvic CT scans of pediatric patients ( Results There was minimal SSDE variability by age. Median SSDE at 100 kV on one scanner model was 5.2 mGy (5.0–5.4 mGy interquartile range). However, when assessing image quality by applying d′, the age groups separated such that the younger patients had higher d′ values than older patients. Similar trends were seen in all scanners. Conclusions An automated method to assess clinical image quality for pediatric CT provided a metric of image quality that varied as expected across ages (i.e., higher quality for younger patients). This tool affords the establishment of a quality reference level that, in addition to dose estimations currently available, would allow for enhanced assessment (e.g., facilitated audit) of CT imaging performance.