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Medical imaging utilization and associated radiation exposure in children with down syndrome

Emily C Marlow1, Jonathan M Ducore2, Marilyn L Kwan3

  • 1Department of Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia, United States of America.

Plos One
|September 6, 2023
PubMed

Insights

Children with Down syndrome undergo significantly more medical imaging and radiation exposure than their peers, particularly in infancy. This highlights a need for careful consideration of imaging practices in this vulnerable population.

Area of Science:

  • Pediatric radiology
  • Medical imaging
  • Radiation oncology

Background:

  • Children with Down syndrome often require more medical interventions.
  • Understanding radiation exposure in this population is crucial due to increased radiosensitivity.

Purpose of the Study:

  • To evaluate the frequency of medical imaging and associated radiation exposure in children with Down syndrome.
  • To compare imaging rates and radiation doses between children with and without Down syndrome.

Main Methods:

  • Retrospective cohort study of over 4.3 million children (1996-2016).
  • Included 3,095 children diagnosed with Down syndrome.
  • Calculated imaging rates per 100 person-years and red bone marrow dose (mGy).
  • Used overdispersed Poisson regression to estimate relative rates (RR).

Main Results:

  • Children with Down syndrome had higher imaging rates: 9.5x in infants (<1 year) and 2.3x in older children (1-18 years).
  • Specific modalities showed significantly higher rates in children with Down syndrome, including angiography (RR=35.8) and fluoroscopy (RR=11.9).
  • Mean cumulative red bone marrow dose was 2-fold higher in children with Down syndrome (4.7 mGy vs. 1.9 mGy).

Conclusions:

  • Children with Down syndrome experience substantially greater medical imaging and radiation exposure.
  • This increased exposure is particularly pronounced in younger children, who are more susceptible to radiation effects.
  • Clinicians should adopt strategic management decisions for imaging this high-risk pediatric group.
Abstract

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