Imaging, radiation exposure, and attributable cancer risk for neonates with necrotizing enterocolitis

Baird, Robert; Tessier, Rachel; Guilbault, Marie-Pier; Puligandla, Pramod S.; Saint‐Martin, Christine

doi:10.1016/j.jpedsurg.2013.02.016

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…26,27 Hospital admission and neuro-observation without initial CT scans may prevent cancer induction referring to strong evidence for an increased risk of fatal cancer from CT scans in childhood. 28,29 Brenner et al 28 published that pediatric CTs will result in significantly increased lifetime radiation risk. Lifetime cancer mortality risk attributable to radiation exposure from a head CT on a 1-year old child was estimated 0.07% (1 of 1,500).…”

Section: Discussionmentioning

confidence: 99%

“…In neurologically normal children, an evolving intracranial injury can be difficult to recognize initially, especially in infants. 9,29 Children younger than 2 years are more likely to sustain a skull fracture compared with older ones, but do not seem to have a higher incidence of an intracranial bleeding. 9,28,29,34 Retrospectively, the most mentioned reason for a radiograph in our study was a scalp hematoma, which should be an indicator of TBI, especially in infants.…”

Section: Discussionmentioning

confidence: 99%

“…9,29 Children younger than 2 years are more likely to sustain a skull fracture compared with older ones, but do not seem to have a higher incidence of an intracranial bleeding. 9,28,29,34 Retrospectively, the most mentioned reason for a radiograph in our study was a scalp hematoma, which should be an indicator of TBI, especially in infants. 35,36 Recent multicenter studies showed that TBI is rare in children with isolated scalp hematoma (0.4%), and no patient required neurosurgery.…”

Section: Discussionmentioning

confidence: 99%

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Can a CT be Omitted in Pediatric Minor Head Trauma?

et al. 2017

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This study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Can a CT be Omitted in Pediatric Minor Head Trauma?

et al. 2017

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“…Diagnosis is based on clinical presentation, laboratory testing and imaging. Traditionally, the gold standard for imaging evaluation of the neonatal intestine is the intestinal gas pattern on plain abdominal radiographs; however interpretation can be challenging with intestinal gas pattern being nonspecific [37][38][39], and significant overlap between radiographic signs of NEC and other intestinal pathology [40].…”

Section: Bowelmentioning

confidence: 99%

Current Neonatal Applications of Point-of-Care Ultrasound

Kim¹,

Shalygin²,

Safarulla³

2018

Current Topics in Intensive Care Medicine

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Point-of-care ultrasound (POCUS) is an imaging modality that continues to gain acceptance in pediatric and neonatal medicine. In neonatology throughout many areas of the world, functional echocardiography performed by neonatologists has been at the forefront in the growth of POCUS compared to non-cardiac POCUS, the latter which potentially carries more opportunities for use. Despite the early adoption in obstetrics and maternal-fetal medicine, the actual bedside implementation in neonatology has unfortunately been much slower. Examples in neonatology where POCUS may continue to expand include central line placement, endotracheal tube localization, diagnosis of pneumothoraces, cardiac function assessment, and bowel viability assessment just to name a few. This chapter will be a practical synopsis of the most active uses and opportunities for POCUS in neonatology. Expanded training for neonatologists and trainees is required before widespread adoption occurs.

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“…Despite the relatively low dose from a single radiograph, neonates may require multiple radiographs. The relative risk of lifetime cancer mortality from radiographs performed over the duration of a NICU admission for patients with necrotizing enterocolitis has been estimated at 4 to 20 times higher than baseline controls 15 . Although recent studies were unable to find any significant effects of low‐dose radiation on cognitive function, limiting the radiation exposure to neonates and the general scattering radiation to health care workers and families in the NICU may help decrease general anxiety, especially if the diagnostic information can be obtained by other means 16 .…”

mentioning

confidence: 99%