Establishing Pediatric Thoracic Radiography Diagnostic Reference Levels Using CALDOSE_X: A Data-Driven Approach to Optimize Radiation Safety

Purpose: Disparities exist in adherence to national radiation safety standards in Morocco, particularly in pediatric conventional radiology. This cross-sectional study aims to establish Moroccan diagnostic reference levels (DRLs) for pediatric thorax radiography. Materials and Methods: Thorax radiographs of 208 pediatric patients (newborns to 18 years old) from four Moroccan public hospitals were analyzed. Patient demographics (age, gender, weight) and scan parameters were recorded to calculate radiation doses using CALDOSE_X 5.0 software, focusing on entrance surface air kerma (ESAK, mGy) and kerma-area product (KAP, mGy·cm²). Patients were categorized into five age groups (