Diagnostic radiation exposure in children with spinal dysraphism: an estimation of the cumulative effective dose in a cohort of 135 children from The Netherlands

Aalst, Jasper van; Jeukens, Cécile R. L. P. N.; Vles, Johan S.H.; Maren, Emiel A van; Kessels, Alfons G.H.; Soudant, Dan; Weber, Jacobiene W.; Postma, Alida A.; Cornips, Erwin M. J.

doi:10.1136/archdischild-2012-303621

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…For non-contrast CT scans of the head, the effective radiation dose in our centre using standard protocol was 2.49 mSv. This is higher than the estimates of 1.5–1.8 mSv in one paper from the Netherlands,24 but consistent with other literature where mean doses delivered for children under 5 years old varied between 2.1 and 3.5 mSv 25–27…”

Section: Discussionsupporting

confidence: 90%

Radiation doses in diagnostic imaging for suspected physical abuse

et al. 2019

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ObjectiveTo measure the actual radiation dose delivered by imaging techniques commonly used in the radiography of suspected physical abuse and to make this information available to health professionals and families.MethodsData were collected retrospectively on children under 3 years referred for skeletal surveys for suspected physical abuse, non-contrast CT head scan or radionuclide imaging of the bones in Starship Children’s Hospital, Auckland, New Zealand from January to December 2015. Patient size-specific conversion coefficients were derived from International Commission on Radiologic Protection tissue weighting factors and used to calculate effective dose.ResultsSeventy-one patients underwent an initial skeletal survey, receiving a mean effective dose of 0.20 mSv (95% CI 0.18 to 0.22). Sixteen patients had a follow-up survey with a mean effective dose of 0.10 mSv (95% CI 0.08 to 0.11). Eighty patients underwent CT head which delivered a mean effective dose of 2.49 mSv (95% CI 2.37 to 2.60). Thirty-nine patients underwent radionuclide bone imaging which delivered a mean effective dose of 2.27 mSv (95% CI 2.11 to 2.43).ConclusionsIn a paediatric centre, skeletal surveys deliver a relatively low effective radiation dose, equivalent to approximately 1 month of background radiation. Non-contrast CT head scan and radionuclide bone imaging deliver similar doses, equivalent to approximately 1 year of background radiation. This information should be considered when gaining informed consent and incorporated in patient education handouts.

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Section: Discussionsupporting

confidence: 90%

Radiation doses in diagnostic imaging for suspected physical abuse

et al. 2019

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“…Infants and children up to 2 years are most likely to have a skeletal survey for suspected abuse, and extrapolating from the above references8 21 a child may be exposed to 3.3–5.4 mSv of radiation following two skeletal surveys (initial and follow-up) and a head CT scan for thorough investigation of suspected physical abuse. This would be an additional lifetime risk of 0.053%–0.088% (using the risk of 0.016% per mSv) of developing cancer.…”

Section: Radiation Exposure Due To Imaging In Child Abusementioning

confidence: 98%

“…This reflects the risk of non-uniform exposure to ionising radiation relative to whole body exposure, allows comparison of risks among various radiological procedures and is measured in units of milliSievert (mSv) 21. The other variables which affect the ‘effective radiation dose’ include the machine output, the distance between the source and patient and the patient's body surface area, and thus for the same procedure the amount of radiation a patient is exposed to may vary from one institution to another.…”

Section: Measuring Radiation and Effects Of Radiationmentioning

confidence: 99%

“…A study from Netherlands by van Aalst et al 21 assessed the cumulative effective dose of diagnostic radiation exposure in children with spinal dysraphism, and based on a risk of 16% per Sv or 0.016% per mSv of developing cancer, calculated that a mean exposure of 23 mSV of developing cancer and concluded that a mean exposure of 23 mSv of diagnostic radiation during childhood would result in an additional lifetime risk of 0.37% (23×0.016) to induce cancer and therefore a very small increase in the lifetime risk of developing cancer.…”

Section: Why Are Children At a Higher Risk From Radiation?mentioning

confidence: 99%

“…Estimates for individual procedures and for various ages have been very helpfully tabulated in an article investigating diagnostic radiation exposure in children with spinal dysraphism 21. According to this reference, a head CT equates to a radiation dose of 1.5–1.9 mSv per study in a child aged between 0 and 2.5 years.…”

Section: Radiation Exposure Due To Imaging In Child Abusementioning

confidence: 99%

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Imaging in suspected child abuse: necessity or radiation hazard?

Bajaj¹,

Offiah

2015

Arch Dis Child

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Imaging has many uses, but in cases of suspected child abuse, radiographs and CT scans are vital in identifying fractures and head injury that may not be clinically obvious. There are growing concerns about the small but potential adverse effects of radiation, including cancer, in the paediatric population as a result of imaging. The vast majority of general paediatricians undertaking child abuse assessments request skeletal surveys and CT scans, subjecting children to significant amounts of radiation. Informed consent must be taken from parents for these procedures and therefore this paper aims to look at evidence of the dangers of radiation in children and raise awareness among paediatricians.

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