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Published on: February 2, 2015
Cumulative diagnostic imaging radiation exposure in premature neonates
Mona Khattab1, Joseph Hagan1, Lawrence H Staib2
1Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Insights
Premature infants in the neonatal intensive care unit (NICU) receive significant cumulative effective radiation doses (cED) from diagnostic imaging. Higher radiation exposure is linked to longer hospital stays and conditions like intestinal perforation.
Area of Science:
- Neonatal intensive care
- Pediatric radiology
- Radiation oncology
Background:
- Limited research exists on the total cumulative effective radiation dose (cED) for infants in neonatal intensive care units (NICUs).
- Previous studies often exclude certain ionizing radiation types, underestimating total exposure in vulnerable infant populations.
- This study quantifies the cED from all diagnostic imaging in premature infants (≤32 weeks gestation) during their NICU stay.
Purpose of the Study:
- To estimate the cumulative effective radiation dose (cED) in microSieverts (μSv) for premature infants (≤32 weeks gestation) in a NICU.
- To identify predictors of radiation exposure in this vulnerable patient group.
- To inform radiation safety protocols in neonatal care.
Main Methods:
- Retrospective chart review of 1045 infants from 2004-2011.
- Data collected included demographics, gestational age (GA), birth weight (BW), length of stay (LOS), clinical diagnoses, and all radiological studies.
- Cumulative effective radiation dose (cED) was calculated for each infant.
Main Results:
- Median GA was 30.0 weeks, median BW was 1340.0 grams, and median LOS was not provided.
- Median cED was 162 μSv (range 0-9248 μSv).
- cED positively correlated with LOS and inversely with GA and BW. Infants with intestinal perforation had significantly higher median cED (1661 μSv) compared to others (162 μSv).
Conclusions:
- This study provides an estimate of cED in premature infants within a level 4 NICU.
- Predictors of higher radiation exposure include shorter gestational age, lower birth weight, longer length of stay, and conditions like intestinal perforation.
- Radiation exposure is highest in the most premature infants and those with intestinal perforation, highlighting areas for targeted radiation dose reduction strategies.
Background:
To date, there has been limited work evaluating the total cumulative effective radiation dose received by infants in the neonatal intensive care unit. Most previous publications report that the total radiation dose received falls within the safe limits but does not include all types of ionizing radiation studies typically performed on this vulnerable patient population. We aimed to provide an estimate of the cumulative effective ionizing radiation dose (cED) in microSieverts (μSv) received by premature infants ≤32 weeks from diagnostic studies performed throughout their NICU stay, and predictors of exposures.
Methods:
Retrospective chart review from 2004-2011. Data included demographics, gestational age (GA), birth weight (BW), length of stay (LOS), clinical diagnosis, and radiological studies.
Results:
1045 charts were reviewed. Median GA = 30.0 weeks (SD 2.7, range 22.0-32.6). Median BW = 1340.0 grams (SD 445.4, range 420-2470). Median number of radiographic studies = 9 (SD 28.5, range 0-210). Median cED = 162μSv (range 0-9248). The cED was positively associated with LOS (p < 0.001) and inversely correlated with GA (p < 0.001) and BW (p < 0.001). Infants with intestinal perforation had the highest median cED 1661μSv compared to 162μSv for others (p < 0.001).
Conclusion:
Our results provide an estimate of the cumulative effective radiation dose received by premature infants in a level 4 neonatal intensive care unit from all radiological studies involving ionizing radiation and identifies risk factors and predictors of such exposure. Radiation exposure in NICU is highest among the most premature and among infants who suffer from intestinal perforation.
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