Optimization of pediatric head CT protocols and dose reduction by radiology technologists in Cameroon, Benin, and Senegal

This study evaluates the role of radiology technologists in optimizing pediatric head computed tomography (CT) protocols and reducing radiation dose indices across three African countries (Cameroon, Senegal, and Benin), with the aim of promoting standardized CT practices in resource-limited settings. Data from 286 pediatric patients (<18 years) undergoing head CT were retrospectively analyzed across six scanner models (Siemens, Hitachi, Neusoft). To evaluate the technologist's role, we noted that local technologists manually set acquisition parameters due to the lack of dedicated pediatric protocols, with those trained in radiation protection primarily optimized dose levels by adjusting the tube voltage (kVp) based on patient age groups (≤1, 1-5, 5-10, and 10-15 years). Local dosimetric indices (CT dose index volume (CTDIvol) and dose length product (DLP)) were compiled and compared. Median CTDIvol values ranged from 14.4 to 22.8 mGy in Benin, 28.6 to 39.2 mGy in Senegal, and 24.7 to 53.9 mGy in Cameroon. Despite differences in scanner models and protocols, image quality was considered clinically acceptable, reflecting standard protocol practices where CT parameters are managed by technologists, and highlighting the potential value of closer regional collaboration among imaging professionals. These findings emphasize the importance of harmonizing imaging practices to strengthen dose optimization and patient radiation protection. This multi-country study demonstrates substantial variability in pediatric head CT dose indices across three African countries and highlights the importance of harmonized protocols, quality assurance, and continued training in dose optimization practices.