Estimation of effective dose and lifetime attributable risk from multiple head CT scans in ventriculoperitoneal shunted children

Abstract

Purpose The purpose of this review is to determine the averaged effective dose and lifetime attributable risk factor from multiple head computed tomography (CT) dose data on children with ventriculoperitoneal shunts (VPS). Method and materials A total of 422 paediatric head CT exams were found between October 2008 and January 2011 and retrospectively reviewed. The CT dose data was weighted with the latest IRCP 103 conversion factor to obtain the effective dose per study and the averaged effective dose was calculated. Estimates of the lifetime attributable risk were also calculated from the averaged effective dose using a conversion factor from the latest BEIR VII report. Results Our study found the highest effective doses in neonates and the lowest effective doses were observed in the 10–18 years age group. We estimated a 0.007% potential increase risk in neonates and 0.001% potential increased risk in teenagers over the base risk. Conclusion Multiple head CTs in children equates to a slight potential increase risk in lifetime attributable risk over the baseline risk for cancer, slightly higher in neonates relative to teenagers. The potential risks versus clinical benefit must be assessed.

Differences in radiation dose for computed tomography of the brain among pediatric patients at the emergency departments: an observational study

“…The age-stratified effective doses of CT brain studies were higher in the younger age groups compared to older age groups; a finding in line with recent publications which supports the inverse relationship between effective dose and age [43,44]. However, the effective doses for pediatric CT brain studies performed by general EDs were higher, reaching statistical significance in those aged three and above, adding further evidence to the literature that non-dedicated pediatric centers exposed patients to higher radiation doses during CT studies [45][46][47].…”

Risk of Brain Tumor Induction from Pediatric Head CT Procedures: A Systematic Literature Review

“…Finally, we identified three published studies [ 19 20 36 ] describing specific pediatric patient populations that considered the cumulative radiation exposure and attributable tumor risks from head CTs over their course of care ( Table 4 ).…”

“…Children, in particular, are markedly more susceptible to radiation-induced cancer than adults [ 14 ], and the lifetime attributable risk (LAR) of malignancy from a single head CT may be more than ten-fold higher for an infant than for a middle-aged adult patient [ 5 15 16 ]. Furthermore, patients with conditions requiring repeat CT exams (i.e., traumatic brain injury [ 17 18 ] or cerebrospinal fluid shunts [ 19 20 ]) receive cumulative radiation doses that magnify the potential risk.…”

Irradiation provided by dental radiological procedures in a pediatric population

“…However, the median effective dose for CBCT was lower than 0.3 mSv which placed this examination in the range of doses for mammography or pelvis radiography [23]. Also, the CBCT effective doses were much lower than the mean effective dose observed in children exposed to CT (1.06 mSv) [25].…”