Related Experiment Video
Updated: May 2, 2026
Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
Published on: March 11, 2021
Diagnostic ionizing radiation exposure in premature patients
M V Scott1, A M Fujii2, R H Behrman3
1Boston University School of Public Health, Boston, MA, USA.
Insights
Diagnostic radiation exposure in premature infants in neonatal intensive care units (NICUs) is a growing concern. This study found that 12.1% of infants received excessive radiation, with gastrointestinal evaluations contributing the most.
Area of Science:
- Neonatal medicine
- Pediatric radiology
- Medical physics
Background:
- Improved survival rates in premature infants have heightened concerns about diagnostic radiation exposure in Neonatal Intensive Care Units (NICUs).
- Radiation monitoring is often inadequate for NICU patients.
Purpose of the Study:
- To quantify ionizing radiation exposure in premature infants (<33 weeks gestational age).
- To identify indications for diagnostic imaging in this population.
- To compare exposure levels with recommended limits.
Main Methods:
- Retrospective review of 215 premature infants (<33 weeks gestation) who underwent central venous line (CVL) placement.
- Estimation of absorbed ionizing radiation using a validated method.
- Comparison of estimated radiation doses with established safety limits.
Main Results:
- Infants received an average of 15±15 radiographs, with specific counts for CVL placement, gastrointestinal (GI), and respiratory indications.
- 12.1% of infants exceeded the maximum recommended radiation dose of 1000 μSv when fluoroscopic procedures were included.
- Central venous line placement accounted for 22% of the total radiation exposure.
Conclusions:
- A significant percentage of premature infants in the NICU setting exceed recommended ionizing radiation limits.
- Gastrointestinal evaluations represent the largest source of radiation exposure.
- Alternative imaging strategies should be explored to minimize radiation in this vulnerable population.
Objective:
Concern regarding the magnitude and consequences of diagnostic radiation exposure in premature infants in neonatal intensive care units (NICUs) has increased as survival of premature infants has improved. Radiation exposure is not often rigorously monitored in NICU patients. The purpose of this observational study was to quantify the amount of ionizing radiation exposure in infants <33 weeks gestational age and to identify the indications for diagnostic imaging.
Study Design:
We conducted a retrospective review of 215 premature infants who were <33 weeks gestation and who received central venous line (CVL) placement during their NICU stay during the period from 2006 to 2011. Absorbed ionizing radiation was estimated using the method of Puch-Kapst and colleagues (2009) and compared with recommended radiation exposure limits. All infants were 29.2±2.3 weeks (mean±s.d.) and 1262±433 g birth weight.
Result:
Subjects received 15±15 radiographs (4.4±2.9 for CVL placement, 5.7±9.8 for gastrointestinal (GI) evaluations and 5.2±9.3 for respiratory indications). Eleven infants (5.1%) received more than the maximum recommended radiation from radiographs (>1000 μSv). Inclusion of fluoroscopic procedures increased to 26 the number of infants (12.1%) who received more than the maximum recommended 1000 μSv.
Conclusion:
Ionizing radiation exposure that exceeded the recommended maximum in premature infants at high risk for long-term sequelae occurred in 12.1% of infants who were <33 weeks gestation and who were cared for in our NICU over the past 5 years. CVL placement accounted for 22% of this radiation exposure. GI evaluations accounted for the greatest amount of ionizing radiation exposure. We suggest that the increased use of other imaging strategies may reduce total ionizing radiation exposure in this vulnerable population.
Related Concept Videos
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:30Radiological Investigation I: X-ray and CT
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:24X-ray Imaging
01:29Positron Emission Tomography
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body...