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Children are more vulnerable to the late somatic effects and genetic effects of radiation than adults; therefore, every effort should be made to keep the dose as low as reasonably achievable, trying to retrieve the best possible information when performing indicated diagnostic tests. Minimizing radiation doses should be a concept applied in a chain of actions, starting from the appropriate choice of modern equipment in the Radiology Department. Pediatric-oriented protocols, especially with regard to CT protocols, regular quality assurance tests, and continuous training of staff involved, are important parts of this chain. Radiation protection rules should be meticulously applied in neonates and children. Justification of requested examinations, vetting of referrals for complex examinations, standardization of techniques and procedures, as well as optimization of protection measures are crucial components for ensuring minimization of radiation exposure. Special considerations include shielding of gonads, thyroid and lens, appropriate collimation, posteroanterior projections in females, added filtration, and grid removal. In addition, short exposure times, immobilization or sedation, entertainment, or distracting devices should be applied to eliminate patient motion. Departments can benefit from self-audits and re-evaluation of their procedures. The learning objectives of this review article comprise becoming familiar with the doses and risks associated with typical X-ray diagnostic examinations carried out in pediatric patients and getting accustomed to radiation protection methods and techniques that may be used to minimize exposure to pediatric patients during diagnostic X-ray examinations.

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