Diagnostic medical radiation in pediatric patients with inflammatory bowel disease

Certain diagnostic radiology procedures may expose patients with inflammatory bowel disease (IBD) to radiation and increase the risk for cancer. In the present study, we quantify the acute and cumulative effective dose of diagnostic radiation received by a cohort of pediatric patients with IBD.

Patients with IBD were identified from the medical records of a pediatric tertiary care center. The number and type of radiology procedures for each patient were determined from medical record review. Cumulative effective radiation dose was calculated using radiation effective dose estimates.

One hundred five patients with IBD underwent radiation-associated abdominopelvic diagnostic radiology procedures with an average cumulative radiation exposure dose of 15 (18) [mean (SD)] mSv. Forty-two percent of the patients were exposed to acute radiation doses ≥10 mSv, and 6 patients (6%) were exposed to levels of cumulative radiation exposure ≥50 mSv, which has been associated with an increased risk of cancer development. Patients with Crohn disease, an increased number of hospital admissions, and a history of surgery were more likely to have been exposed to higher levels of cumulative radiation than their clinical counterparts.

A majority of patients with IBD are exposed to radiation from typical diagnostic radiology procedures. Radiation-sparing procedures should be strongly considered in certain pediatric patients with IBD to reduce their risk for cancer given an already present increased lifetime malignancy potential.