Estimation of Effective Dose and Lifetime Attributable Risk from Multiple Head CT Scans in Ventriculoperitoneal Shunted Children

Overview

Journal Eur J Radiol

Specialty Radiology

Date 2014 Aug 19

PMID 25130177

Citations 5

Authors

J Aw-Zoretic

D Seth

G Katzman

S Sammet

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this review is to determine the averaged effective dose and lifetime attributable risk factor from multiple head computed tomography (CT) dose data on children with ventriculoperitoneal shunts (VPS).

Method And Materials: A total of 422 paediatric head CT exams were found between October 2008 and January 2011 and retrospectively reviewed. The CT dose data was weighted with the latest IRCP 103 conversion factor to obtain the effective dose per study and the averaged effective dose was calculated. Estimates of the lifetime attributable risk were also calculated from the averaged effective dose using a conversion factor from the latest BEIR VII report.

Results: Our study found the highest effective doses in neonates and the lowest effective doses were observed in the 10-18 years age group. We estimated a 0.007% potential increase risk in neonates and 0.001% potential increased risk in teenagers over the base risk.

Conclusion: Multiple head CTs in children equates to a slight potential increase risk in lifetime attributable risk over the baseline risk for cancer, slightly higher in neonates relative to teenagers. The potential risks versus clinical benefit must be assessed.

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References

Patel M, Klufas R, Alberico R, Edelman R . Half-fourier acquisition single-shot turbo spin-echo (HASTE) MR: comparison with fast spin-echo MR in diseases of the brain. AJNR Am J Neuroradiol. 1997; 18(9):1635-40. PMC: 8338455. View

. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007; 37(2-4):1-332. DOI: 10.1016/j.icrp.2007.10.003. View

Kan L, Nagelberg J, Maytal J . Headaches in a pediatric emergency department: etiology, imaging, and treatment. Headache. 2000; 40(1):25-9. DOI: 10.1046/j.1526-4610.2000.00004.x. View

Smith A, Dillon W, Lau B, Gould R, Verdun F, Lopez E . Radiation dose reduction strategy for CT protocols: successful implementation in neuroradiology section. Radiology. 2008; 247(2):499-506. DOI: 10.1148/radiol.2472071054. View

Brenner D, Hall E . Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007; 357(22):2277-84. DOI: 10.1056/NEJMra072149. View

Iskandar B, Sansone J, Medow J, Rowley H . The use of quick-brain magnetic resonance imaging in the evaluation of shunt-treated hydrocephalus. J Neurosurg. 2005; 101(2 Suppl):147-51. DOI: 10.3171/ped.2004.101.2.0147. View

Huda W . Effective doses to adult and pediatric patients. Pediatr Radiol. 2002; 32(4):272-9. DOI: 10.1007/s00247-002-0680-0. View

Huda W, Vance A . Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol. 2007; 188(2):540-6. DOI: 10.2214/AJR.06.0101. View

Haacke E, Tkach J . Fast MR imaging: techniques and clinical applications. AJR Am J Roentgenol. 1990; 155(5):951-64. DOI: 10.2214/ajr.155.5.2120964. View

10.

Mettler Jr F, Wiest P, Locken J, Kelsey C . CT scanning: patterns of use and dose. J Radiol Prot. 2001; 20(4):353-9. DOI: 10.1088/0952-4746/20/4/301. View

11.

Raaschou-Nielsen O, Andersen C, Andersen H, Gravesen P, Lind M, Schuz J . Domestic radon and childhood cancer in Denmark. Epidemiology. 2008; 19(4):536-43. DOI: 10.1097/EDE.0b013e318176bfcd. View

12.

Ozasa K, Shimizu Y, Suyama A, Kasagi F, Soda M, Grant E . Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: an overview of cancer and noncancer diseases. Radiat Res. 2011; 177(3):229-43. DOI: 10.1667/rr2629.1. View

13.

Fearon T . CT dose parameters and their limitations. Pediatr Radiol. 2002; 32(4):246-9. DOI: 10.1007/s00247-002-0676-9. View

14.

Deak P, Smal Y, Kalender W . Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology. 2010; 257(1):158-66. DOI: 10.1148/radiol.10100047. View

15.

Ward E, DeSantis C, Robbins A, Kohler B, Jemal A . Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014; 64(2):83-103. DOI: 10.3322/caac.21219. View

16.

Lee C, Lee C, Han E, Bolch W . Consideration of the ICRP 2006 revised tissue weighting factors on age-dependent values of the effective dose for external photons. Phys Med Biol. 2006; 52(1):41-58. DOI: 10.1088/0031-9155/52/1/004. View

17.

Christner J, Kofler J, McCollough C . Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol. 2010; 194(4):881-9. DOI: 10.2214/AJR.09.3462. View

18.

Schick S, Heimberger K, Linnau K, Schibany N, Prokesch R, Trattnig S . Ultrafast magnetic resonance imaging of the brain. Magn Reson Imaging. 2000; 18(3):237-43. DOI: 10.1016/s0730-725x(99)00140-x. View

19.

Mettler Jr F, Huda W, Yoshizumi T, Mahesh M . Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008; 248(1):254-63. DOI: 10.1148/radiol.2481071451. View

20.

Tobias J, Leder M . Procedural sedation: A review of sedative agents, monitoring, and management of complications. Saudi J Anaesth. 2011; 5(4):395-410. PMC: 3227310. DOI: 10.4103/1658-354X.87270. View