Radiation exposure by medical X-ray applications

Abstract

Background: Radioactive material and ionising radiation play a central role in medical diagnostics and therapy. The benefit of ionising radiation is opposed by the risk of irreparable damage of the human organism. This risk, especially for developing malign neoplasms, has particularly been investigated in the population surviving the atomic bombing of Hiroshima and Nagasaki, but also increasingly in persons with occupational or medical exposure to ionising radiation. Methods: We conducted a systematic search for publications in English and German in relevant databases in March 2016. Retrievals were screened by two independent reviewers. We included examinations using imaging procedures with ionising radiation. The assessment of methodological quality was done concerning representativeness, risk of bias, and further limitations, and reporting quality was assessed using the RECORD checklist. Results: The systematic searches identified seven cross-sectional, one register, and four cohort studies. An increase in collective effective doses analogue to the increase of computed tomography (CT) examinations could be observed. An increased risk of brain tumours in children after exposition to head CT and by an increase of the number of examinations was shown. For children with predisposing factors, an increased risk of tumours of the central nerve system, leukemia, and lymphoma was found. Furthermore, a general risk for malign neoplasms or haemoblastoma, and a specific risk for lymphoma after CT examinations of different parts of the body could be observed. Discussion: Taking into consideration a mostly unclear representativeness of studies and an unclear or high risk of bias as well as lack of comparability due to different research questions, the validity of results is limited. Conclusion: The risk of bias due to a large number of reference sources must be reduced in studies leading to realistic estimates of collective radiation doses. The risk of CT-induced radiation exposure for children should be investigated by further studies with a follow-up of at least ten years.

Microtia Ear Reconstruction with Patient-Specific 3D Models—A Segmentation Protocol

“…CT has some disadvantages, such as its high cost or the patient s exposure to radiation. Considering that most of the patients undergoing ear reconstruction are infants and adolescents, there is concern about the effects of radiation exposure, such as an increased risk of tumors of the central nervous system, leukemia and lymphoma, although this is still unclear [15].…”

Preclinical Models for Cryptococcosis of the CNS and Their Characterization Using In Vivo Imaging Techniques

“…Figure 2C illustrates the use of preclinical CT in a multimodal approach, combining CT, BLI, and MRI to study the temporal evolution from an initial pulmonary infection to the dissemination to the brain [179]. While the use of ionizing radiation in CT imaging is a potential concern, in particular for repeated follow-up imaging [266,267], no radiotoxicity was found in carefully designed longitudinal studies [268]. In addition to dedicated applications in pulmonary infectious disease models, CT also provides an anatomical reference frame for imaging modalities that lack anatomical information, like PET and SPECT.…”

Surgical Treatment of Pleural Empyema in Children

“…The need for chest x-rays in pleuropneumonia for diagnosis and treatment control in relation to radiation corresponds to the sum of each of them. It is not dangerous from the point of view of radiation biology unlike computed tomography [37,38].…”