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Ionizing Radiation Exposure Inequities in the Diagnostic Imaging of Children With Complex Chronic Conditions

Michael P George1,2,3, Jay G Berry1,2,3,4, Patrice Melvin3,5

  • 1Department of Radiology, Boston Children's Hospital, Boston, Massachusetts.

Pediatrics
|August 31, 2025
PubMed

Insights

Children with complex chronic conditions (CCCs) face higher ionizing radiation exposure from medical imaging. Neurologic/neuromuscular CCCs significantly increase cumulative radiation risks and repeated CT scans.

Area of Science:

  • Pediatric Medical Imaging
  • Radiology
  • Public Health

Background:

  • Limiting ionizing radiation exposure is crucial in pediatric care.
  • Potential inequities in radiation exposure exist for children with complex chronic conditions (CCCs).

Purpose of the Study:

  • To compare the likelihood of ionizing radiation exposure in children with and without CCCs.
  • To investigate disparities in radiation exposure among pediatric patients.

Main Methods:

  • Retrospective analysis of 1,013,034 encounters in 47 children's hospitals (2022-2023).
  • Matched comparison of children with CCCs (identified by ICD-10 codes) to those without.
  • Longitudinal analysis over 1 year, including multivariable and separate analyses for neurologic/neuromuscular (N/NM) CCCs and CT exposure.

Main Results:

  • Children with N/NM or other CCCs showed a greater likelihood of radiation exposure.
  • Longitudinally, N/NM CCCs had the highest risk of cumulative ionizing radiation exposure (aOR 3.31).
  • Children with N/NM CCCs were more likely to receive multiple CT scans (aOR 2.57).

Conclusions:

  • Children with CCCs, especially N/NM, experience disproportionate radiation exposure in medical imaging.
  • Significant repeated radiation exposures were observed longitudinally in children with CCCs.
Abstract

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