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Published on: September 11, 2011
Radiation dose and excess risk of cancer in children undergoing neuroangiography
Colin A Raelson1, Kalpana M Kanal, Monica S Vavilala
1Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA. colin.raelson@mssm.edu
Insights
Pediatric neuroangiography and CT scans deliver radiation doses, increasing lifetime cancer risk by about 1%. Minimizing radiation exposure in pediatric patients undergoing these procedures is crucial.
Area of Science:
- Radiology
- Pediatric Imaging
- Radiation Oncology
Background:
- Diagnostic and interventional neuroangiography are vital for pediatric care.
- Assessing radiation exposure is critical for long-term patient safety.
- Understanding cancer risks associated with medical imaging is an ongoing concern.
Purpose of the Study:
- To determine radiation doses in pediatric neuroangiographic procedures.
- To estimate total radiation exposure from all angiographic and CT studies in children.
- To approximate the increased cancer incidence risk in this pediatric cohort.
Main Methods:
- Retrospective analysis of pediatric patients undergoing neuroangiography (2004-2008).
- Radiation doses converted to entrance skin dose (ESD) and effective dose (ED).
- Cancer risk estimated using the Biologic Effects of Ionizing Radiation (BEIR) VII report.
Main Results:
- Mean effective dose (ED) was 10.4 mSv (diagnostic) and 34.0 mSv (interventional).
- Entrance skin dose (ESD) values were below thresholds for deterministic harm.
- Estimated excess cancer cases represent a ~1% increase in lifetime attributable risk.
Conclusions:
- Neuroangiography and CT scans offer significant patient benefits.
- Continued investigation into adverse effects of medical imaging technologies is necessary.
- Implementing dose-minimizing protocols without compromising diagnostic quality is recommended.
Objective:
The primary goal of this study was to determine the radiation dose received during diagnostic and interventional neuroangiographic procedures in a group of pediatric patients. A second goal was to approximate the total average radiation dose from all angiographic and CT studies that pediatric patients underwent during the study period and to estimate the increased risk of cancer incidence in this patient group.
Materials And Methods:
The study subjects were pediatric patients who had undergone one or more neuroangiographic procedures at Harborview Medical Center between December 1, 2004, and April 30, 2008. Recorded radiation doses were converted to entrance skin dose (ESD) and effective dose (ED) to indicate deterministic and stochastic damage, respectively. The Biologic Effects of Ionizing Radiation (BEIR) VII, phase 2, report was used to estimate the expected increased risk of cancer in the study population.
Results:
For diagnostic and therapeutic procedures, a mean ED of 10.4 and 34.0 mSv per procedure was calculated, respectively. The ESD values proved too low to cause deterministic harm. The estimated number of excess cases of malignancy projected from the total average radiation exposure was 890.6 per 100,000 exposed male children and 1,222.5 per 100,000 exposed females, an overall increase of approximately 1% to the lifetime attributable risk of cancer.
Conclusion:
Although both angiography and CT have revolutionized the practice of medicine and confer benefits to patients, it is important that we continue to investigate the possible adverse effects of these technologies. Protocols that minimize radiation dose without compromising a study should be implemented.
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