Hospital for Sick Children, Department of Diagnostic Imaging, and Department of Medical Imaging, University of Toronto, 555 University Ave, Toronto, Ontario M5G 1X8, Canada.
Pediatrics. 2010 Oct;126(4):e851-8. doi: 10.1542/peds.2009-2675. Epub 2010 Sep 27.
Our aim was to estimate the cumulative effective doses (CEDs) from radiologic procedures for a cohort of pediatric oncology patients.
A retrospective cohort study of the imaging histories of 150 pediatric oncology patients (30 each in 5 subgroups, that is, leukemia, lymphomas, brain tumors, neuroblastomas, and assorted solid tumors) for 5 years after diagnosis was performed. All procedures involving ionizing radiation were recorded, including radiography, computed tomography (CT), nuclear medicine (NM) studies, fluoroscopy, and interventional procedures. CED estimates were calculated.
Individual CED estimates ranged from <1 mSv to 642 mSv, with a median of 61 mSv. CT and NM were the greatest contributors; CT constituted 30% of procedures but 52% of the total CED, and NM constituted 20% and 46%, respectively. There was considerable variability between tumor subgroups. CED estimates were highest in the neuroblastoma (median: 213 mSv [range: 36-489 mSv]) and lymphoma (median: 191 mSv [range: 10-642 mSv]) groups and lowest in the leukemia group (median: 5 mSv [range: 0.2-57 mSv]).
CEDs from diagnostic and interventional imaging for pediatric oncology patients vary considerably according to diagnoses, individual clinical courses, and imaging modalities used. Increased awareness may promote strategies to reduce the radiation burden to this population.
我们旨在评估一组儿科肿瘤患者放射学检查的累积有效剂量（CED）。
对 150 例儿科肿瘤患者（诊断后 5 年内每 5 例一组，分别为白血病、淋巴瘤、脑肿瘤、神经母细胞瘤和各种实体瘤）的影像学检查史进行回顾性队列研究。记录所有涉及电离辐射的检查，包括放射摄影、计算机断层扫描（CT）、核医学（NM）研究、透视和介入性操作。计算 CED 估计值。
个体 CED 估计值从<1 mSv 到 642 mSv 不等，中位数为 61 mSv。CT 和 NM 是最大的贡献者；CT 占检查的 30%，但占总 CED 的 52%，NM 分别占 20%和 46%。肿瘤亚组之间存在相当大的差异。神经母细胞瘤（中位数：213 mSv [范围：36-489 mSv]）和淋巴瘤（中位数：191 mSv [范围：10-642 mSv]）组的 CED 估计值最高，白血病组（中位数：5 mSv [范围：0.2-57 mSv]）最低。
根据诊断、个体临床病程和使用的影像学方式，儿科肿瘤患者的诊断和介入性影像学检查的 CED 差异很大。提高认识可能会促进为该人群减少辐射负担的策略。
