TY  - JOUR
AU  - Vassileva, J.
AU  - Rehani, M.
AU  - Kostova-Lefterova, D.
AU  - Al-Naemi, H. M.
AU  - Al Suwaidi, J. S.
AU  - Aranđić, Danijela
AU  - Bashier, E. H. O.
AU  - Kodlulovich Renha, S.
AU  - El-Nachef, L.
AU  - Aguilar, J. G.
AU  - Gershan, Vesna
AU  - Gershkevitsh, E.
AU  - Gruppetta, E.
AU  - Hustuc, A.
AU  - Jauhari, A.
AU  - Kharita, Mohammad Hassan
AU  - Khelassi-Toutaoui, N.
AU  - Khosravi, H. R.
AU  - Khoury, H.
AU  - Kralik, I.
AU  - Mahere, S.
AU  - Mazuoliene, J.
AU  - Mora, P.
AU  - Muhogora, W.
AU  - Muthuvelu, P.
AU  - Nikodemova, D.
AU  - Novak, L.
AU  - Pallewatte, A.
AU  - Pekarovic, D.
AU  - Shaaban, M.
AU  - Shelly, E.
AU  - Stepanyan, K.
AU  - Thelsy, N.
AU  - Visrutaratna, P.
AU  - Zaman, A.
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/668
AB  - The article reports from the largest international dose survey in paediatric computed tomography (CT) in 32 countries and proposes international diagnostic reference levels (DRLs) in terms of computed tomography dose index (CTDIvol) and dose length product (DLP). It also assesses whether mean or median values of individual facilities should be used. A total of 6115 individual patient data were recorded among four age groups: LT 1 y, GT 1-5 y, GT 5-10 y and GT 10-15 y. CTDIw, CTDIvol and DLP from the CT console were recorded in dedicated forms together with patient data and technical parameters. Statistical analysis was performed, and international DRLs were established at rounded 75th percentile values of distribution of median values from all CT facilities. The study presents evidence in favour of using median rather than mean of patient dose indices as the representative of typical local dose in a facility, and for establishing DRLs as third quartile of median values. International DRLs were established for paediatric CT examinations for routine head, chest and abdomen in the four age groups. DRLs for CTDIvol are similar to the reference values from other published reports, with some differences for chest and abdomen CT. Higher variations were observed between DLP values, based on a survey of whole multi-phase exams. It may be noted that other studies in literature were based on single phase only. DRLs reported in this article can be used in countries without sufficient medical physics support to identify non-optimised practice. Recommendations to improve the accuracy and importance of future surveys are provided.
T2  - Radiation Protection Dosimetry
T1  - A Study to Establish International Diagnostic Reference Levels for Paediatric Computed Tomography
VL  - 165
IS  - 1-4
SP  - 70
EP  - 80
DO  - 10.1093/rpd/ncv116
ER  - 

@article{
author = "Vassileva, J. and Rehani, M. and Kostova-Lefterova, D. and Al-Naemi, H. M. and Al Suwaidi, J. S. and Aranđić, Danijela and Bashier, E. H. O. and Kodlulovich Renha, S. and El-Nachef, L. and Aguilar, J. G. and Gershan, Vesna and Gershkevitsh, E. and Gruppetta, E. and Hustuc, A. and Jauhari, A. and Kharita, Mohammad Hassan and Khelassi-Toutaoui, N. and Khosravi, H. R. and Khoury, H. and Kralik, I. and Mahere, S. and Mazuoliene, J. and Mora, P. and Muhogora, W. and Muthuvelu, P. and Nikodemova, D. and Novak, L. and Pallewatte, A. and Pekarovic, D. and Shaaban, M. and Shelly, E. and Stepanyan, K. and Thelsy, N. and Visrutaratna, P. and Zaman, A.",
year = "2015",
abstract = "The article reports from the largest international dose survey in paediatric computed tomography (CT) in 32 countries and proposes international diagnostic reference levels (DRLs) in terms of computed tomography dose index (CTDIvol) and dose length product (DLP). It also assesses whether mean or median values of individual facilities should be used. A total of 6115 individual patient data were recorded among four age groups: LT 1 y, GT 1-5 y, GT 5-10 y and GT 10-15 y. CTDIw, CTDIvol and DLP from the CT console were recorded in dedicated forms together with patient data and technical parameters. Statistical analysis was performed, and international DRLs were established at rounded 75th percentile values of distribution of median values from all CT facilities. The study presents evidence in favour of using median rather than mean of patient dose indices as the representative of typical local dose in a facility, and for establishing DRLs as third quartile of median values. International DRLs were established for paediatric CT examinations for routine head, chest and abdomen in the four age groups. DRLs for CTDIvol are similar to the reference values from other published reports, with some differences for chest and abdomen CT. Higher variations were observed between DLP values, based on a survey of whole multi-phase exams. It may be noted that other studies in literature were based on single phase only. DRLs reported in this article can be used in countries without sufficient medical physics support to identify non-optimised practice. Recommendations to improve the accuracy and importance of future surveys are provided.",
journal = "Radiation Protection Dosimetry",
title = "A Study to Establish International Diagnostic Reference Levels for Paediatric Computed Tomography",
volume = "165",
number = "1-4",
pages = "70-80",
doi = "10.1093/rpd/ncv116"
}

Vassileva, J., Rehani, M., Kostova-Lefterova, D., Al-Naemi, H. M., Al Suwaidi, J. S., Aranđić, D., Bashier, E. H. O., Kodlulovich Renha, S., El-Nachef, L., Aguilar, J. G., Gershan, V., Gershkevitsh, E., Gruppetta, E., Hustuc, A., Jauhari, A., Kharita, M. H., Khelassi-Toutaoui, N., Khosravi, H. R., Khoury, H., Kralik, I., Mahere, S., Mazuoliene, J., Mora, P., Muhogora, W., Muthuvelu, P., Nikodemova, D., Novak, L., Pallewatte, A., Pekarovic, D., Shaaban, M., Shelly, E., Stepanyan, K., Thelsy, N., Visrutaratna, P.,& Zaman, A.. (2015). A Study to Establish International Diagnostic Reference Levels for Paediatric Computed Tomography. in Radiation Protection Dosimetry, 165(1-4), 70-80.
https://doi.org/10.1093/rpd/ncv116

Vassileva J, Rehani M, Kostova-Lefterova D, Al-Naemi HM, Al Suwaidi JS, Aranđić D, Bashier EHO, Kodlulovich Renha S, El-Nachef L, Aguilar JG, Gershan V, Gershkevitsh E, Gruppetta E, Hustuc A, Jauhari A, Kharita MH, Khelassi-Toutaoui N, Khosravi HR, Khoury H, Kralik I, Mahere S, Mazuoliene J, Mora P, Muhogora W, Muthuvelu P, Nikodemova D, Novak L, Pallewatte A, Pekarovic D, Shaaban M, Shelly E, Stepanyan K, Thelsy N, Visrutaratna P, Zaman A. A Study to Establish International Diagnostic Reference Levels for Paediatric Computed Tomography. in Radiation Protection Dosimetry. 2015;165(1-4):70-80.
doi:10.1093/rpd/ncv116 .

Vassileva, J., Rehani, M., Kostova-Lefterova, D., Al-Naemi, H. M., Al Suwaidi, J. S., Aranđić, Danijela, Bashier, E. H. O., Kodlulovich Renha, S., El-Nachef, L., Aguilar, J. G., Gershan, Vesna, Gershkevitsh, E., Gruppetta, E., Hustuc, A., Jauhari, A., Kharita, Mohammad Hassan, Khelassi-Toutaoui, N., Khosravi, H. R., Khoury, H., Kralik, I., Mahere, S., Mazuoliene, J., Mora, P., Muhogora, W., Muthuvelu, P., Nikodemova, D., Novak, L., Pallewatte, A., Pekarovic, D., Shaaban, M., Shelly, E., Stepanyan, K., Thelsy, N., Visrutaratna, P., Zaman, A., "A Study to Establish International Diagnostic Reference Levels for Paediatric Computed Tomography" in Radiation Protection Dosimetry, 165, no. 1-4 (2015):70-80,
https://doi.org/10.1093/rpd/ncv116 . .

TY  - JOUR
AU  - Vassileva, Jenia
AU  - Rehani, Madan M.
AU  - Al-Dhuhli, Humoud
AU  - Al-Naemi, Huda M.
AU  - Al-Suwaidi, Jamila Salem
AU  - Appelgate, Kimberly
AU  - Aranđić, Danijela
AU  - Bashier, Einas Hamed Osman
AU  - Beganovic, Adnan
AU  - Benavente, Tony
AU  - Bieganski, Tadeusz
AU  - Dias, Simone
AU  - El-Nachef, Leila
AU  - Faj, Dario
AU  - Gamarra-Sanchez, Mirtha E.
AU  - Garcia-Aguilar, Juan
AU  - Gbelcova, L'ubka
AU  - Gershan, Vesna
AU  - Gershkevitsh, Eduard
AU  - Gruppetta, Edward
AU  - Hustuc, Alexandru
AU  - Ivanović, Sonja
AU  - Jauhari, Arif
AU  - Kharita, Mohammad Hassan
AU  - Kharuzhyk, Siarhei
AU  - Khelassi-Toutaoui, Nadia
AU  - Khosravi, Hamid Reza
AU  - Khoury, Helen
AU  - Kostova-Lefterova, Desislava
AU  - Kralik, Ivana
AU  - Liu, Lantao
AU  - Mazuoliene, Jolanta
AU  - Mora, Patricia
AU  - Muhogora, Wilbroad
AU  - Muthuvelu, Pirunthavany
AU  - Novak, Leos
AU  - Pallewatte, Aruna S.
AU  - Shaaban, Mohamed
AU  - Shelly, Esti
AU  - Stepanyan, Karapet
AU  - Teo, Eu-Leong Harvey J.
AU  - Thelsy, Naw
AU  - Visrutaratna, Pannee
AU  - Zaman, Areesha
AU  - Zontar, Dejan
PY  - 2012
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4810
AB  - OBJECTIVE. The purpose of this study was to assess the frequency of pediatric CT in 40 less-resourced countries and to determine the level of appropriateness in CT use. MATERIALS AND METHODS. Data on the increase in the number of CT examinations during 2007 and 2009 and appropriate use of CT examinations were collected, using standard forms, from 146 CT facilities at 126 hospitals. RESULTS. The lowest frequency of pediatric CT examinations in 2009 was in European facilities (4.3%), and frequencies in Asia (12.2%) and Africa (7.8%) were twice as high. Head CT is the most common CT examination in children, amounting to nearly 75% of all pediatric CT examinations. Although regulations in many countries assign radiologists with the main responsibility of deciding whether a radiologic examination should be performed, in fact, radiologists alone were responsible for only 6.3% of situations. Written referral guidelines for imaging were not available in almost one half of the CT facilities. Appropriateness criteria for CT examinations in children did not always follow guidelines set by agencies, in particular, for patients with accidental head trauma, infants with congenital torticollis, children with possible ventriculoperitoneal shunt malfunction, and young children ( LT 5 years old) with acute sinusitis. In about one third of situations, nonavailability of previous images and records on previously received patient doses have the potential to lead to unnecessary examinations and radiation doses. CONCLUSION. With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.
T2  - American Journal of Roentgenology
T1  - IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness
VL  - 198
IS  - 5
SP  - 1021
EP  - 1031
DO  - 10.2214/AJR.11.7273
ER  - 

@article{
author = "Vassileva, Jenia and Rehani, Madan M. and Al-Dhuhli, Humoud and Al-Naemi, Huda M. and Al-Suwaidi, Jamila Salem and Appelgate, Kimberly and Aranđić, Danijela and Bashier, Einas Hamed Osman and Beganovic, Adnan and Benavente, Tony and Bieganski, Tadeusz and Dias, Simone and El-Nachef, Leila and Faj, Dario and Gamarra-Sanchez, Mirtha E. and Garcia-Aguilar, Juan and Gbelcova, L'ubka and Gershan, Vesna and Gershkevitsh, Eduard and Gruppetta, Edward and Hustuc, Alexandru and Ivanović, Sonja and Jauhari, Arif and Kharita, Mohammad Hassan and Kharuzhyk, Siarhei and Khelassi-Toutaoui, Nadia and Khosravi, Hamid Reza and Khoury, Helen and Kostova-Lefterova, Desislava and Kralik, Ivana and Liu, Lantao and Mazuoliene, Jolanta and Mora, Patricia and Muhogora, Wilbroad and Muthuvelu, Pirunthavany and Novak, Leos and Pallewatte, Aruna S. and Shaaban, Mohamed and Shelly, Esti and Stepanyan, Karapet and Teo, Eu-Leong Harvey J. and Thelsy, Naw and Visrutaratna, Pannee and Zaman, Areesha and Zontar, Dejan",
year = "2012",
abstract = "OBJECTIVE. The purpose of this study was to assess the frequency of pediatric CT in 40 less-resourced countries and to determine the level of appropriateness in CT use. MATERIALS AND METHODS. Data on the increase in the number of CT examinations during 2007 and 2009 and appropriate use of CT examinations were collected, using standard forms, from 146 CT facilities at 126 hospitals. RESULTS. The lowest frequency of pediatric CT examinations in 2009 was in European facilities (4.3%), and frequencies in Asia (12.2%) and Africa (7.8%) were twice as high. Head CT is the most common CT examination in children, amounting to nearly 75% of all pediatric CT examinations. Although regulations in many countries assign radiologists with the main responsibility of deciding whether a radiologic examination should be performed, in fact, radiologists alone were responsible for only 6.3% of situations. Written referral guidelines for imaging were not available in almost one half of the CT facilities. Appropriateness criteria for CT examinations in children did not always follow guidelines set by agencies, in particular, for patients with accidental head trauma, infants with congenital torticollis, children with possible ventriculoperitoneal shunt malfunction, and young children ( LT 5 years old) with acute sinusitis. In about one third of situations, nonavailability of previous images and records on previously received patient doses have the potential to lead to unnecessary examinations and radiation doses. CONCLUSION. With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.",
journal = "American Journal of Roentgenology",
title = "IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness",
volume = "198",
number = "5",
pages = "1021-1031",
doi = "10.2214/AJR.11.7273"
}

Vassileva, J., Rehani, M. M., Al-Dhuhli, H., Al-Naemi, H. M., Al-Suwaidi, J. S., Appelgate, K., Aranđić, D., Bashier, E. H. O., Beganovic, A., Benavente, T., Bieganski, T., Dias, S., El-Nachef, L., Faj, D., Gamarra-Sanchez, M. E., Garcia-Aguilar, J., Gbelcova, L., Gershan, V., Gershkevitsh, E., Gruppetta, E., Hustuc, A., Ivanović, S., Jauhari, A., Kharita, M. H., Kharuzhyk, S., Khelassi-Toutaoui, N., Khosravi, H. R., Khoury, H., Kostova-Lefterova, D., Kralik, I., Liu, L., Mazuoliene, J., Mora, P., Muhogora, W., Muthuvelu, P., Novak, L., Pallewatte, A. S., Shaaban, M., Shelly, E., Stepanyan, K., Teo, E. H. J., Thelsy, N., Visrutaratna, P., Zaman, A.,& Zontar, D.. (2012). IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness. in American Journal of Roentgenology, 198(5), 1021-1031.
https://doi.org/10.2214/AJR.11.7273

Vassileva J, Rehani MM, Al-Dhuhli H, Al-Naemi HM, Al-Suwaidi JS, Appelgate K, Aranđić D, Bashier EHO, Beganovic A, Benavente T, Bieganski T, Dias S, El-Nachef L, Faj D, Gamarra-Sanchez ME, Garcia-Aguilar J, Gbelcova L, Gershan V, Gershkevitsh E, Gruppetta E, Hustuc A, Ivanović S, Jauhari A, Kharita MH, Kharuzhyk S, Khelassi-Toutaoui N, Khosravi HR, Khoury H, Kostova-Lefterova D, Kralik I, Liu L, Mazuoliene J, Mora P, Muhogora W, Muthuvelu P, Novak L, Pallewatte AS, Shaaban M, Shelly E, Stepanyan K, Teo EHJ, Thelsy N, Visrutaratna P, Zaman A, Zontar D. IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness. in American Journal of Roentgenology. 2012;198(5):1021-1031.
doi:10.2214/AJR.11.7273 .

Vassileva, Jenia, Rehani, Madan M., Al-Dhuhli, Humoud, Al-Naemi, Huda M., Al-Suwaidi, Jamila Salem, Appelgate, Kimberly, Aranđić, Danijela, Bashier, Einas Hamed Osman, Beganovic, Adnan, Benavente, Tony, Bieganski, Tadeusz, Dias, Simone, El-Nachef, Leila, Faj, Dario, Gamarra-Sanchez, Mirtha E., Garcia-Aguilar, Juan, Gbelcova, L'ubka, Gershan, Vesna, Gershkevitsh, Eduard, Gruppetta, Edward, Hustuc, Alexandru, Ivanović, Sonja, Jauhari, Arif, Kharita, Mohammad Hassan, Kharuzhyk, Siarhei, Khelassi-Toutaoui, Nadia, Khosravi, Hamid Reza, Khoury, Helen, Kostova-Lefterova, Desislava, Kralik, Ivana, Liu, Lantao, Mazuoliene, Jolanta, Mora, Patricia, Muhogora, Wilbroad, Muthuvelu, Pirunthavany, Novak, Leos, Pallewatte, Aruna S., Shaaban, Mohamed, Shelly, Esti, Stepanyan, Karapet, Teo, Eu-Leong Harvey J., Thelsy, Naw, Visrutaratna, Pannee, Zaman, Areesha, Zontar, Dejan, "IAEA Survey of Pediatric CT Practice in 40 Countries in Asia, Europe, Latin America, and Africa: Part 1, Frequency and Appropriateness" in American Journal of Roentgenology, 198, no. 5 (2012):1021-1031,
https://doi.org/10.2214/AJR.11.7273 . .

TY  - JOUR
AU  - Rehani, Madan M.
AU  - Ciraj-Bjelac, Olivera
AU  - Al-Naemi, Huda M.
AU  - Al-Suwaidi, Jamila Salem
AU  - El-Nachef, Leila
AU  - Khosravi, Hamid Reza
AU  - Kharita, Mohammad Hassan
AU  - Muthuvelu, Pirunthavany
AU  - Pallewatte, Aruna S.
AU  - Juan, Bayani Cruz San
AU  - Shaaban, Mohamed
AU  - Zaman, Areesha
PY  - 2012
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/5021
AB  - Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20-85% of cases, and manual processing is in 5-85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10-40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16-19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
T2  - European Journal of Radiology
T1  - Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project
VL  - 81
IS  - 10
SP  - E982
EP  - E989
DO  - 10.1016/j.ejrad.2012.06.019
ER  - 

@article{
author = "Rehani, Madan M. and Ciraj-Bjelac, Olivera and Al-Naemi, Huda M. and Al-Suwaidi, Jamila Salem and El-Nachef, Leila and Khosravi, Hamid Reza and Kharita, Mohammad Hassan and Muthuvelu, Pirunthavany and Pallewatte, Aruna S. and Juan, Bayani Cruz San and Shaaban, Mohamed and Zaman, Areesha",
year = "2012",
abstract = "Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20-85% of cases, and manual processing is in 5-85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10-40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16-19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement. (c) 2012 Elsevier Ireland Ltd. All rights reserved.",
journal = "European Journal of Radiology",
title = "Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project",
volume = "81",
number = "10",
pages = "E982-E989",
doi = "10.1016/j.ejrad.2012.06.019"
}

Rehani, M. M., Ciraj-Bjelac, O., Al-Naemi, H. M., Al-Suwaidi, J. S., El-Nachef, L., Khosravi, H. R., Kharita, M. H., Muthuvelu, P., Pallewatte, A. S., Juan, B. C. S., Shaaban, M.,& Zaman, A.. (2012). Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project. in European Journal of Radiology, 81(10), E982-E989.
https://doi.org/10.1016/j.ejrad.2012.06.019

Rehani MM, Ciraj-Bjelac O, Al-Naemi HM, Al-Suwaidi JS, El-Nachef L, Khosravi HR, Kharita MH, Muthuvelu P, Pallewatte AS, Juan BCS, Shaaban M, Zaman A. Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project. in European Journal of Radiology. 2012;81(10):E982-E989.
doi:10.1016/j.ejrad.2012.06.019 .

Rehani, Madan M., Ciraj-Bjelac, Olivera, Al-Naemi, Huda M., Al-Suwaidi, Jamila Salem, El-Nachef, Leila, Khosravi, Hamid Reza, Kharita, Mohammad Hassan, Muthuvelu, Pirunthavany, Pallewatte, Aruna S., Juan, Bayani Cruz San, Shaaban, Mohamed, Zaman, Areesha, "Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project" in European Journal of Radiology, 81, no. 10 (2012):E982-E989,
https://doi.org/10.1016/j.ejrad.2012.06.019 . .