Does clinical indication play a role in CT radiation dose in pediatric patients?

By: Sotiria Triantopoulou an dVerginia Tsapaki

Highlights
• The diseases associated with multiple CT examinations in children are identified.

• Children with malignancy are exposed to high radiation doses from CT examinations.

• Children with malignancies have an increased risk for radiation-induced cancer.

• The necessity of minimizing the CT radiation dose of these patients is emphasized.

Abstract
Purpose
The purpose of this study was to identify the main pathologies for which CT is applied on pediatric patients and the related radiation doses as reported in the literature in order to facilitate justification and CT optimization.

Methods
A critical analysis of a literature review was performed. Different search engines were used such as PubMed, Google Scholar and Science Direct. Various terms and keywords were used to locate pertinent articles such as Pediatric, Computed tomography, Radiation Dose, Organ dose, Effective dose.

Results
The results showed that the main pathologies for which CT is applied are: Crohn’s disease, hydrocephalus, cystic fibrosis and pediatric malignancies-mainly lymphoma. The related radiation dose data are extremely scarce and are in the range of 3.48–17.56, 0.2–15.3 mSv, 0.14–6.20 mSv, and 2.8–518.0 mSv, respectively. The radiation doses reported are high especially in pediatric oncology.

Conclusions
Pediatric patients with malignancies are those exposed to the higher levels of radiation during CT imaging. Literature is lacking reporting of dose in Pediatric CT imaging. More studies need to be realized for the determination of radiation dose in those patients. Special protocols need to be recommended in order to reduce the exposure of children in radiation.

Keywords
Pediatric, Computed tomography, Effective dose

1. Introduction
The last decades due to recent technologic advances, the number of Computed Tomography (CT) examinations performed has been widely increased. The development of this modality from single-detector to helical and to multi-detector has offered many advantages in clinical practice rendering CT the examination of choice for many clinical indications. This results in high radiation exposure of patients leading to raising concerns about its broadened use [1], [2]. It is estimated that [Read more…]