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Total estimated effective doses from radiologic imaging modalities of children with cancer: a single center experience

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Abstract

Background

Recently, awareness of the cumulative radiation exposure for pediatric oncology patients has been increasing, together with increased survival rates and longer life expectancy. The aim of our study was to quantify the amount of ionising radiation from imaging modalities of pediatric oncology patients.

Methods

Eighty-eight patients who were diagnosed with childhood cancer and followed up for 5 years between 2004-2014 in our center were included in the study. Patients’ medical files were reviewed retrospectively for imaging history in the first 5 years after diagnosis. Total estimated effective doses from radiologic imaging modalities were determined. Also, the basic demographic data, histologic type, stage, and outcomes of disease were collected for all patients.

Results

The individual total estimated effective doses ranged from 8.73 to 167 mSv, with a median of 62.92 mSv. Computed tomography was the greatest contributor of total effective doses. The doses ranged 21.45-113.20 mSv (median: 62.92 mSv) in Hodgkin lymphoma, 12.53-167.10 mSv (median: 52 mSv) in non-Hodgkin lymphoma, 4.13-172.98 mSv (median: 52 mSv) in neuroblastoma, 31-149.89 mSv (median: 63.10 mSv) in Wilms’ tumor, 11.50-73.72 mSv (median: 36.90 mSv) in germ cell tumor, 26.46-125.86 mSv (median: 80.90 mSv) in other solid tumor and 0.02-13.31 mSv (5.25 mSv) in brain tumor subgroup. Twenty-two children (25%) died with progressive disease during the 5-year follow-up period.

Conclusions

Similar to previous studies, the total estimated effective doses in children with cancer have been found various according to diagnosis, stage and clinical course. To clarify the harmfull effects of radiation burden, prospective studies should be conducted in children with cancer.

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References

  1. Brody AS, Frush DP, Huda W, Brent RL; American Academy of Pediatrics Section on Radiology. Radiation risk to children from computed tomography. Pediatrics 2007;120:677–682.

    Article  PubMed  Google Scholar 

  2. Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med 2007;357:2277–2284.

    Article  PubMed  CAS  Google Scholar 

  3. Mettler FA, Thomadsen BR, Bhargavan M, Gilley DB, Gray JE, Lipoti JA, et al. Medical radiation exposure in the U.S. in 2006: preliminary results. Health Phys 2008;95:502–507.

    Article  PubMed  CAS  Google Scholar 

  4. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 2001;176:289–296.

    Article  PubMed  CAS  Google Scholar 

  5. Robbins E. Radiation risks from imaging studies in children with cancer. Pediatr Blood Cancer 2008;51:453–457.

    Article  PubMed  Google Scholar 

  6. Brenner DJ. Effective dose: a flawed concept that could and should be replaced. Br J Radiol 2008;81:521–523.

    Article  PubMed  CAS  Google Scholar 

  7. Ahmed BA, Connolly BL, Shroff P, Chong AL, Gordon C, Grant R, et al. Cumulative effective doses from radiologic procedures for pediatric oncology patients. Pediatrics 2010;126:e851–e858.

    Article  PubMed  Google Scholar 

  8. Chawla SC, Federman N, Zhang D, Nagata K, Nuthakki S, McNitt-Gray M, et al. Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review. Pediatr Radiol 2010;40:681–686.

    Article  PubMed  Google Scholar 

  9. Gelfand MJ, Sharp SE, Treves ST, Fahey FH, Parisi MT, Alessio AM. Estimated cumulative radiation dose from PET/CT in children with malignancies. Pediatr Radiol 2010;40:1712–1713.

    Article  PubMed  Google Scholar 

  10. Pierobon J, Webber CE, Nayiager T, Barr RD, Moran GR, Gulenchyn KY. Radiation doses originating from diagnostic procedures during the treatment and follow-up of children and adolescents with malignant lymphoma. J Radiol Prot 2011;31:83–93.

    Article  PubMed  Google Scholar 

  11. Chong AL, Grant RM, Ahmed BA, Thomas KE, Connolly BL, Greenberg M. Imaging in pediatric patients: time to think again about surveillance. Pediatr Blood Cancer 2010;55:407–413.

    Article  PubMed  Google Scholar 

  12. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukemia and brain tumours: a retrospective cohort study. Lancet 2012;380:499–505.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, et al. Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 2013;346:f2360.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lee E, Goo HW, Lee JY. Age-and gender-specific estimates of cumulative CT dose over 5 years using real radiation dose tracking data in children. Pediatr Radiol 2015;45:1282–1292.

    Article  PubMed  Google Scholar 

  15. Biasotti S, Garaventa A, Padovani P, Faraci M, Fioredda F, Hanau G, et al. Role of active follow-up for early diagnosis of relapse after elective end of therapies. Pediatr Blood Cancer 2005;45:781–786.

    Article  PubMed  Google Scholar 

  16. Guppy AE, Tebbutt NC, Norman A, Cunningham D. The role of surveillance CT scans in patients with diffuse large B-cell non-Hodgkin’s lymphoma. Leuk Lymphoma 2003;44:123–125.

    Article  PubMed  CAS  Google Scholar 

  17. Dryver ET, Jernström H, Tompkins K, Buckstein R, Imrie KR. Follow-up of patients with Hodgkin’s disease following curative treatment: the routine CT scan is of little value. Br J Cancer 2003;89:482–486.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Elis A, Blickstein D, Klein O, Eliav-Ronen R, Manor Y, Lishner M. Detection of relapse in non-Hodgkin’s lymphoma: role of routine follow-up studies. Am J Hematol 2002;69:41–44.

    Article  PubMed  Google Scholar 

  19. The 2007 recommandations of the international commission on radiological protection, ICRP publication 103. Ann ICRP 2007;37:1–332.

    Google Scholar 

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Correspondence to Derya Özyörük.

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Özyörük, D., Emir, S., Demir, H.A. et al. Total estimated effective doses from radiologic imaging modalities of children with cancer: a single center experience. World J Pediatr 13, 242–247 (2017). https://doi.org/10.1007/s12519-016-0049-3

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  • DOI: https://doi.org/10.1007/s12519-016-0049-3

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