[Intl_DxMedPhys] EXT MSG Re: [EXTERNAL] Re: ACR CT Pediatric Clinical Image Question

Tue Apr 1 16:55:06 EDT 2025

I did see that use of the word “perceived” and found that to be extremely clear! Jk.

I took some effective diameter measurements of the patient and compared to “U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations.” Looks like the DRL based on this data would be 11 mGy. I wonder if the ACR will make any changes to their reference levels and/or pass/fail levels in the future. I’m quite certain that those have not changed in the past 10 years or so while doses are going down (whether that is a good thing or not is certainly up for debate).

Thanks all!

Best,

Mike
________________________________________
Mike Timmerman, MS, DABR
Diagnostic Medical Physicist
Sanford Health – Sioux Falls Region
Mobile: (541) 213-1075
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From: Gauntt, David <davidgauntt at uabmc.edu>
Sent: Tuesday, April 1, 2025 3:40 PM
To: Douglas Pfeiffer <xraydoug at me.com>; Timmerman,Michael <Michael.Timmerman at SanfordHealth.org>
Cc: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: Re: EXT MSG Re: [Intl_DxMedPhys] [EXTERNAL] Re: ACR CT Pediatric Clinical Image Question

As I said, for clinical images the perceived limit for clinical images is 10mGy for a 40-50lb patient, but for a 175lb I would expect a much higher limit; if anything, I would worry a bit about noise at 11mGy and 175lb.

---
David M. Gauntt, Ph.D.
Associate Professor
Division of Physics and Engineering
Department of Radiology
(205)975-3777

[1647458080270]

________________________________
From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+davidgauntt=uabmc.edu at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces+davidgauntt=uabmc.edu at lists.osu.edu>> on behalf of Timmerman, Michael via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Sent: Tuesday, April 1, 2025 3:33 PM
To: Douglas Pfeiffer
Cc: intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: EXT MSG Re: [Intl_DxMedPhys] [EXTERNAL] Re: ACR CT Pediatric Clinical Image Question

Thanks Doug! Yes, I was referring to the clinical images here. The patient is around 175 lbs. and the CTDI is around 11 mGy (reported using the 32 cm phantom) so I don’t expect the ACR would have an issue with this dose. It’s a bit higher than
Thanks Doug! Yes, I was referring to the clinical images here. The patient is around 175 lbs. and the CTDI is around 11 mGy (reported using the 32 cm phantom) so I don’t expect the ACR would have an issue with this dose. It’s a bit higher than I would like for this age range but not egregious at all.

Best,

Mike
________________________________________
Mike Timmerman, MS, DABR
Diagnostic Medical Physicist
Sanford Health – Sioux Falls Region
Mobile: (541) 213-1075
[Icon  Description automatically generated with medium confidence]

From: Douglas Pfeiffer <xraydoug at me.com<mailto:xraydoug at me.com>>
Sent: Tuesday, April 1, 2025 3:19 PM
To: Timmerman,Michael <Michael.Timmerman at SanfordHealth.org<mailto:Michael.Timmerman at SanfordHealth.org>>
Cc: intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: [EXTERNAL] Re: [Intl_DxMedPhys] ACR CT Pediatric Clinical Image Question

Michael,

The dosimetry is evaluated by the ACR only for that patient size. There is no limit placed on other patient sizes. Please note that the phantom and CTDI testing are independent of the clinical exams that are being submitted.,

Best regards,
Doug

Douglas Pfeiffer, MS, DABR FACR, FAAPM
Medical Physicist, Radiation Safety Officer
Boulder Community Health
xraydoug at me.com<mailto:xraydoug at me.com>
303.415.7515

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The opinions expressed in this message are the product of the gray and white matter loitering in my cranium. I speak for myself and no one else, unless I say otherwise.

On Apr 1, 2025, at 3:03 PM, Timmerman, Michael via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>> wrote:

Hi all,

It’s been a while since I’ve reviewed clinical images for ACR accreditation. I have a quick question regarding pediatric abdomen pelvis exams. The pass/fail criteria is 10 mGy for the 32 cm phantom but this value is for a 40-50 lb. patient; are there any guidelines for pass/fail criteria for older (and therefore larger) pediatric patients who may exceed this level?

Thanks!

Best,

Mike
________________________________________
Mike Timmerman, MS, DABR
Diagnostic Medical Physicist
Sanford Health – Sioux Falls Region
Mobile: (541) 213-1075
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