Empirical Analysis of Radiation Dose Optimisation in Paediatric CT Across Teaching Hospitals in North West and North East Nigeria

Paediatric CT dose optimisation is a critical radiation protection imperative given the heightened radiosensitivity of children, yet empirical multi-centre data on paediatric CT dose practice and optimisation gaps across North West and North East Nigerian teaching hospitals are entirely absent from the literature. This study empirically analyses paediatric CT dose optimisation practices and dose patterns at teaching hospitals across both zones. A multi-centre prospective dose audit recruits all paediatric CT examinations (patients aged 0 to 15 years) performed over a six-month period at eight teaching hospitals in Kano, Kaduna, Zamfara, Borno, Gombe, and Yobe States, documenting CTDIvol, DLP, effective dose, weight-based technique parameter use, tube current modulation activation, and iterative reconstruction use for each examination. Multi-level mixed-effects regression in R identifies site-level and patient-level dose predictors. Available paediatric CT dose literature from North West and North East Nigeria identifies use of adult scan parameters for paediatric patients as the most frequently documented dose escalation cause, yet no regional multi-centre study has quantified this issue. The IAEA paediatric CT diagnostic reference levels and the Image Gently Alliance size-specific dose estimate guidance provide the analytical benchmarks. Findings are expected to reveal dose values significantly exceeding paediatric reference levels across the majority of sites. Recommendations address a regional paediatric CT protocol optimisation workshop, mandatory weight-based parameter adjustment, and dedicated paediatric CT dose audit programmes at North West and North East teaching hospitals. Keywords: paediatric CT, dose optimisation, multi-centre, North West Nigeria, North East Nigeria.