Changes in radiological imaging frequencies in children before and after the accident at the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture, Japan

Yoshida, Kōji; Hayashida, Naomi; Fukushima, Yoshiko; Ohtsuru, Akira; Ohba, Takayoshi; Hasegawa, Arifumi; Satô, Hisashi; Shishido, Fumio; Yasui, Kiyotaka; Kumagai, Atsushi; Yusa, Takeshi; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

doi:10.1007/s11604-015-0464-8

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Although previous studies have suggested that there was a reduction in undergoing CT after the accident, these studies were based on aggregated data on a limited region of Fukushima Prefecture, which was near the plant, or in several children's hospitals. 23,24 A second strength was that the present study used regression discontinuity analysis, a quasi-experimental study design. Random variability implies that patients who visited hospitals before and after the accident will be similar on all observed and unobserved baseline characteristics, mimicking a randomized controlled trial.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Fukushima Daiichi Nuclear Power Plant Accident on the Use of Computed Tomography in Children With Mild Head Injuries

Aso

Matsui

Yasunaga

2020

Journal of Epidemiology

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Background: Computed tomography (CT) is commonly used in children with mild head injuries. People in Japan are concerned about radiation exposure and radiation-induced cancer because of the Fukushima Daiichi Nuclear Power Plant accident on March 11, 2011. This study investigated whether the accident influenced the use of CT in children with mild head injuries. Methods: Using the Japan Medical Data Center database, we identified patients aged ≤15 years visiting hospitals because of mild head injuries from January 1, 2008, to December 31, 2013. We excluded patients who were admitted to the hospital or received other medical examinations. Regression discontinuity analysis was used to compare proportions of patients undergoing head CT and having clinically important traumatic brain injury (ciTBI) overlooked before versus after the accident, adjusting for patient characteristics, secular trends, and hospital effect. Results: Eligible patients (n = 40,440) were classified as visiting the hospital before (n = 11,659) or after (n = 28,781) the accident. The regression discontinuity analysis showed that the accident was associated with a reduction in the proportion of patients undergoing head CT (odds ratio [OR] 0.73; 95% confidence interval [CI], 0.63-0.86), whereas the accident was not associated with an increase in cases where ciTBI was overlooked (OR 0.72; 95% CI, 0.13-4.00). Conclusions: The use of CT in children with mild head injuries declined after the Fukushima Daiichi Nuclear Power Plant accident. Improving awareness of radiation exposure risks among patients and physicians could reduce unnecessary CT.

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Section: Discussionmentioning

confidence: 99%

Influence of the Fukushima Daiichi Nuclear Power Plant Accident on the Use of Computed Tomography in Children With Mild Head Injuries

Aso

Matsui

Yasunaga

2020

Journal of Epidemiology

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“…CT, X-ray, MRI, US, etc.) at Fukushima Medical University hospital before and after the accident [ 31 ]. The number of outpatients of <10 years of age who underwent CT and X-ray examinations significantly decreased after the accident.…”

Section: Future Prospectsmentioning

confidence: 99%

The present state of radiation exposure from pediatric CT examinations in Japan—what do we have to do?

Ideguchi

Yoshida

Ohtsuru

et al. 2018

Journal of Radiation Research

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The use of computed tomography (CT) has increased dramatically over the past several decades and has resulted in a concurrent increase in medical exposure to ionizing radiation. Several recent studies have examined the link between medical radiation and the risk of cancer, especially in children. The cancer risk associated medical exposure has not been definitively confirmed. However, we have to reduce unwarranted medical radiation exposure in pediatric patients. Justification and optimization are of great importance in order to minimize these risks, and the standardization of CT usage is essential. However, in Japan no clinical guidelines for the use of CT have been commonly agreed upon, especially in children. Furthermore, the CT-associated radiation exposure in Japan varies widely among the different facilities. Further studies based on a nationwide survey in Japan will be required in order to establish simple and useful clinical guidelines.

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“…They get relatively higher effective doses because of their higher radiosensitivity. In addition to this, children have a longer lifespan after radiation exposure compared to adults and are also more likely to undergo repeated CT scans throughout their lifetime [ 1 , 6 , 8 ]. The most exposed to ionizing radiation are organs and tissues such as red bone marrow, brain, thyroid gland, etc.…”

Section: Introductionmentioning

confidence: 99%

Local Diagnostic Reference Levels for Paediatric Head CT Procedures

Gricienė

Šiukšterytė²

2021

AML

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Background. Patients, especially children, are exposed to substantially high doses of ionising radiation during computed tomography (CT) procedures. Children are several times more susceptible to ionising radiation than adults. Diagnostic reference levels (DRLs) are an important tool for monitoring and optimising patient radiation exposure from radiological procedures. The aim of this study is to estimate the ionising radiation exposure doses and set local DRLs for head CT examinations according to age and to compare local DRLs with national and European DRLs and with literature data in other countries.Materials and methods. Scan parameters of single-phase head CT examinations were collected. Patients were grouped by age in the following intervals: <1, 1−5, 5−10, 10−15 and 15−18 years. Local age-based DRLs set as the 3rd quartile of the median dose-length product (DLP) were calculated. Literature analysis was performed on PubMed search engine on inclusion criteria: publication date 2015–2020, used keywords paediatric computed tomography, paediatric CT, diagnostic reference levels (DRLs). The 23 articles discussing paediatric DRLs were further analysed.Results. Data was collected from 194 paediatric head CT examinations performed in 2019. The median DLP values for head CT were 144.3, 233.7, 246.4, 288.9, 315.5 for <1, 1−5, 5−10, 10−15 and 15−18 years old groups. Estimated local DRLs for head CT examinations are 170, 300, 310, 320, 360 mGy*cm for <1, 1−5, 5−10, 10−15 and 15−18 years age groups respectively and 130, 210, 275, 320 mGy*cm for 0−3 months, 3 months−1 year, 1−6 years and ≥ 6 years age groups respectively.Conclusions. Results of this study showed that settled new local DRLs of head CT examinations were 2–4 times lower than national DRLs and about 2 times lower than European DRLs. Moreover, the study indicated that paediatric head CT doses are significantly lower in comparison with those indicated in the majority of published data from other hospitals over the last 6 years. Patient dose assessment and local DRLs establishment plays important role in future exposure optimisation.

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Changes in radiological imaging frequencies in children before and after the accident at the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture, Japan

Cited by 6 publications

References 24 publications

Influence of the Fukushima Daiichi Nuclear Power Plant Accident on the Use of Computed Tomography in Children With Mild Head Injuries

Influence of the Fukushima Daiichi Nuclear Power Plant Accident on the Use of Computed Tomography in Children With Mild Head Injuries

The present state of radiation exposure from pediatric CT examinations in Japan—what do we have to do?

Local Diagnostic Reference Levels for Paediatric Head CT Procedures

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