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Radiation exposure from diagnostic radiographs in extremely low birth weight infants
D Wilson-Costello1, P S Rao, S Morrison
1Department of Pediatrics and Radiology, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Radiation doses from radiographs for infants under 750g birth weight are small. Even with conditions like chronic lung disease, the total radiation exposure remains low compared to cancer risk estimates.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Radiation Dosimetry
Background:
- Infants with very low birth weight (<750g) often require frequent radiographic imaging.
- Accurate assessment of radiation exposure in this vulnerable population is crucial for minimizing potential risks.
Purpose of the Study:
- To examine and quantify the radiation doses received by infants weighing less than 750g from diagnostic radiographs.
- To adapt standard radiation dose calculation methods for the unique physiological characteristics of extremely low birth weight infants.
Main Methods:
- Retrospective review of radiology records for 25 surviving infants (<750g birth weight) from 1991.
- Modification of standard neonatal radiation dose calculation to account for infant body size, growth, and extramedullary hematopoiesis.
- Calculation of effective dose equivalent (sum of weighed organ dose equivalents) to determine overall radiation exposure.
Main Results:
- Infants underwent a mean of 31 radiographs, with chest radiographs most frequent in the first month and abdominal radiographs increasing in the second month.
- Single exposures ranged from 0.01–0.04 mSv, with surface organs receiving the highest doses.
- The modified method yielded a total effective dose equivalent of 0.72 mSv per infant, compared to 0.40 mSv by the standard method. Infants with specific conditions received higher doses (up to 1.5 mSv total-body).
Conclusions:
- Radiation doses from radiographs in extremely low birth weight infants are generally small.
- These doses are considerably lower than those associated with established cancer risk estimates.
Objective:
We sought to examine radiation doses received by infants of less than 750 g birth weight from radiographs.
Methods:
We examined the radiology records, including radiograph films, of all 25 surviving infants with birth weight less than 750 g admitted to our center during 1991. The standard method of neonatal radiation dose calculation was modified to consider the body size, postnatal growth, and extramedullary hematopoiesis of the extremely low birth weight infant. To determine overall radiation exposure, we calculated an effective dose equivalent, which is the sum of weighed organ dose equivalents.
Results:
The infants had a mean of 31 radiographys performed, including 17 chest radiographs, 5 babygrams, and 9 abdominal radiographs. The majority of chest radiographs and babygrams were performed in the first month, whereas abdominal radiographs increased during the second month of life. Total-body radiation dose and total effective dose equivalent by the standard and modified methods, respectively, for single exposures ranged from 0.01 to 0.02 millisieverts (mSv) for a chest radiograph, from 0.02 to 0.04 mSv for a babygram, and from 0.02 to 0.03 mSv for an abdominal radiograph. Surface organs icluding the skin, breast, and thyroid received the largest radiation doses. The effective dose equivalent per infant for all radiographs was 0.72 mSv according to the modified method, compared to a total-body dose of 0.40 mSv using the standard method. However, infants with chronic lung disease or necrotizing enterocolitis received up to 1.5 mSv total-body dose, including 3.3 mSv to the breast, 2.5 mSv to the thyroid, and 2.3 mSv to the testes.
Conclusions:
Radiation doses received by infants of less than 750 g birth weight are small in comparison with the range of doses that form the basis of risk estimates for cancer.