Medical radiation exposure in children with bleeding disorders: an institutional experience

Area of Science:

• Pediatric Hematology
• Medical Imaging
• Radiation Oncology

Background:

• Patients with bleeding disorders may require medical imaging, leading to potential ionizing radiation exposure.
• Severe hemophilia and mild bleeding disorders (MBDs) present different clinical management needs, potentially impacting radiation exposure.
• Understanding radiation exposure differences is crucial for optimizing patient care and safety.

Purpose of the Study:

• To compare medical radiation exposure rates between pediatric patients with severe hemophilia and those with MBDs.
• To quantify differences in the number of radiographic studies and effective radiation doses.
• To identify patient groups with high cumulative radiation exposure.

Main Methods:

• Retrospective chart review of 35 pediatric patients with severe hemophilia and matched controls with MBDs (Type 1 von Willebrand disease or mild platelet function defect) from 2000-2010.
• Data collection on radiation exposure in millisieverts (mSv) from radiological studies at Emory/CHOA.
• Statistical comparison of exposure rates using the Mann-Whitney Test.

Main Results:

• Severe hemophilia patients underwent significantly more radiographic studies (mean 11.3 vs. 1.8) compared to MBD controls (P < 0.001).
• Mean annual effective radiation dose was higher in severe hemophilia patients (2 mSv) versus MBD controls (0.4 mSv) (P < 0.001).
• A higher proportion of severe hemophilia patients (31.4%) accumulated high radiation doses (> 20 mSv) compared to controls (1.4%).

Conclusions:

• Pediatric patients with severe hemophilia accumulate significantly greater medical radiation exposure than those with MBDs.
• While radiation is often necessary, minimizing unnecessary exposure and exploring alternative imaging techniques is recommended.
• Further research into low-dose protocols and imaging alternatives is warranted for this vulnerable population.