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Excess Radiation to Newborns Hospitalized in the Intensive Care Unit
Cássio Vilela Komatsu1, Cristiane Camargo Silva1, Luis Ronan Marquez Ferreira de Souza1
1Unidade de Diagnóstico por Imagem, Hospital de Clínicas da Universidade Federal do Triângulo Mineiro - HC/UFTM, Rua Getúlio Guaritá, 130, Nossa Senhora da Abadia, CEP 38025-440, Uberaba, Minas Gerais, Brazil.
Insights
Neonatal intensive care unit (NICU) newborns receive numerous X-rays, risking radiation damage. This study found excessive radiation due to unnecessary procedures, high doses, and poor collimation, highlighting areas for improvement in pediatric radiation safety.
Area of Science:
- Medical Physics
- Pediatric Radiology
- Neonatal Intensive Care
Background:
- Neonates in intensive care units (NICUs) undergo frequent X-ray imaging.
- This exposure carries a risk of radiation-induced damage.
- Optimizing radiation dose and justification is crucial for this vulnerable population.
Purpose of the Study:
- To evaluate radiation exposure in NICU newborns.
- To identify sources of excess radiation, including procedure frequency, dose per radiograph, and beam collimation.
- To propose strategies for reducing radiation risks.
Main Methods:
- Analysis of X-ray procedures performed on NICU newborns.
- Assessment of X-ray frequency, dose, and collimation.
- Comparison of radiation doses with existing studies.
Main Results:
- Mean X-rays per newborn: 12 (range 1-65) over a mean hospitalization of 29 days.
- Approximately 13% of X-rays lacked clear clinical motivation.
- Mean entrance surface dose (72 μGy) was higher than in comparative studies.
- Under-collimation frequently resulted in non-thoracic structures on chest radiographs.
Conclusions:
- Radiation exposure in NICU newborns can be reduced by applying the justification principle for each X-ray.
- Multiprofessional collaboration is recommended for dose optimization.
- Correct use of collimation systems is essential to prevent irradiation of non-thoracic structures.
Abstract:
Newborns in intensive care units are generally subjected to a great number of X-rays procedures and to the risk of radiation-induced damage. This study evaluated a possible excess radiation by excess of radiographs, excess of dose per radiograph or under-collimation of the X-ray beam. The mean of X-rays per newborn was 12 (1-65) during a mean hospitalization of 29 d (1-226 d). The mean frequency was 0.8 X-ray exposures per newborn. About 13% of X-rays were performed without a well-defined clinical motivation. The mean entrance surface dose of 72 μGy was higher than in most of comparative studies. Under-collimation caused non-thoracic structures to appear frequently on chest radiographs. This study indicates a possible reduction in X-rays exposures by applying the justification principle for each X-ray procedure, recommends a multiprofessional work in the attempt to dose optimization, and shows need of correctly use of collimation system to avoid irradiation of non-thoracic structures.
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