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Quantifying and Contextualizing Radiation Doses in Common Pediatric Medical Imaging Examinations
Carly Stewart1, Susan Alber2, Malini Mahendra3,4
1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
Journal of Pediatrics. Clinical Practice
|August 18, 2025
Summary
Computed tomography (CT) scans account for 80% of pediatric radiation exposure, with doses to the bone marrow and brain linked to increased cancer risk, especially in younger children. This study quantifies these pediatric imaging doses.
Area of Science:
- Radiology
- Pediatric Imaging
- Radiation Oncology
Background:
- Pediatric imaging involves radiation exposure, necessitating accurate dose assessment for risk evaluation.
- Understanding organ and effective doses is crucial for informed clinical decisions and risk-benefit analysis in pediatric radiology.
Purpose of the Study:
- To determine organ and effective radiation doses for common pediatric imaging examinations.
- To aid clinicians in understanding site-specific cancer risks and comparing radiation exposure across different imaging modalities.
Main Methods:
- A retrospective cohort study analyzed over 835,000 imaging examinations in 278,909 children from 2012-2017.
- Radiation doses for computed tomography (CT) were estimated using technical parameters and Monte Carlo simulations.
- Dose maps for fluoroscopy, angiography, nuclear medicine, and radiography were developed based on patient demographics and technical data.
Main Results:
- CT examinations constituted 4% of all imaging but contributed 80% of the total radiation dose.
- Head CT, the most frequent CT exam, delivered an average bone marrow dose of 9.8 mGy and brain dose of 39 mGy.
- Radiographs were most common but accounted for only 6% of the overall radiation dose exposure.
Conclusions:
- CT radiation doses to the bone marrow and brain are within ranges associated with increased cancer risk.
- Radiation doses are highest in the youngest pediatric patients, highlighting the need for careful consideration in this age group.
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