Related Experiment Video
Updated: Aug 12, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Radiological Studies in Very Low Birth Weight and Extremely Low Birth Weight Neonates: 'ALARA' Revisited
Surjit Damon Jeetoo1, Johan Smith2, Richard Denys Pitcher1
1Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa.
Insights
Extremely low birth weight (ELBW) and very low birth weight (VLBW) neonates in resource-limited settings undergo significant radiographic exposure. ELBW neonates received higher radiation doses than VLBW neonates, highlighting disparities in care.
Area of Science:
- Neonatal imaging
- Radiology
- Pediatric radiation dose
Background:
- Very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates are highly vulnerable to ionizing radiation effects.
- Limited data exist on radiographic practices for these vulnerable populations in resource-limited environments.
Purpose of the Study:
- To estimate the cumulative effective dose (ED) from diagnostic imaging in VLBW and ELBW neonates within a resource-limited setting.
- To analyze radiographic practices and radiation exposure in these specific neonatal groups.
Main Methods:
- Retrospective analysis of diagnostic imaging examinations in ELBW and VLBW neonates from a South African tertiary hospital (Jan-June 2015).
- Data stratified by birth weight and imaging type; effective dose estimated using the Puch-Kapst method.
- Non-parametric t-tests compared radiographic numbers and ED between VLBW and ELBW neonates.
Main Results:
- 393 neonates (265 VLBW, 128 ELBW) were analyzed. Median ED was 28.8 μSv per neonate.
- ELBW neonates received significantly higher median ED (71.2 μSv) compared to VLBW neonates (14.4 μSv).
- Radiographic exposure for VLBW neonates was lower than previously reported.
Conclusions:
- Neonatal radiographic practices in resource-limited settings are crucial for informing international best practices.
- Findings highlight the need for optimized radiation dose management in vulnerable neonatal populations globally.
Background:
Very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates are particularly susceptible to the adverse effects of ionizing radiation. There are limited data on radiographic practice among this population in resource-limited environments.
Aim:
To estimate cumulative effective dose (ED) from diagnostic imaging in VLBW (1000-1500 g) and ELBW (<1000 g) neonates in a resource-limited setting.
Method:
A retrospective analysis of all diagnostic imaging examinations performed on ELBW and VLBW neonates born in a large South African public-sector tertiary-level hospital from January through June 2015. Data were stratified by birth weight and imaging examination. The ED was estimated according to the method of Puch-Kapst. Non-parametric t-tests compared the number of radiographs and ED in VLBW and ELBW neonates, at 5% significance.
Results:
Three hundred and ninety-three neonates with median birth weight 1130 (IQR: 930-1340) g were included; 265 (67%) were VLBW and 128 (33%) ELBW; 48 (12%) died at a median of 7 (IQR: 2-17) days. A median of 2 (IQR: 1-5) radiographs were performed per neonate, with median ED 28.8 (IQR: 14.4-90.8) μSv. The median radiographic exposures for VLBW and ELBW neonates were 1 (IQR: 1-4) and 4 (IQR: 2-9), respectively, (p < 0.0001) with median ED 14.4 (IQR: 14.4-70.4) μSv and 71.2 (IQR: 28.8-169.3) μSv, respectively, (p < 0.0001). Radiographic exposure for VLBW neonates was lower than previously documented for this population.
Conclusion:
Neonatal radiographic practice in resource-limited settings has the potential to contribute to the discourse on international best practice.
Related Concept Videos
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...