Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Department of Public Health Sciences, University of California, Davis, CA, USA.
Cancer Causes Control. 2022 May;33(5):711-726. doi: 10.1007/s10552-022-01556-z. Epub 2022 Feb 2.
The Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging (RIC) Study is quantifying the association between cumulative radiation exposure from fetal and/or childhood medical imaging and subsequent cancer risk. This manuscript describes the study cohorts and research methods.
The RIC Study is a longitudinal study of children in two retrospective cohorts from 6 U.S. healthcare systems and from Ontario, Canada over the period 1995-2017. The fetal-exposure cohort includes children whose mothers were enrolled in the healthcare system during their entire pregnancy and followed to age 20. The childhood-exposure cohort includes children born into the system and followed while continuously enrolled. Imaging utilization was determined using administrative data. Computed tomography (CT) parameters were collected to estimate individualized patient organ dosimetry. Organ dose libraries for average exposures were constructed for radiography, fluoroscopy, and angiography, while diagnostic radiopharmaceutical biokinetic models were applied to estimate organ doses received in nuclear medicine procedures. Cancers were ascertained from local and state/provincial cancer registry linkages.
The fetal-exposure cohort includes 3,474,000 children among whom 6,606 cancers (2394 leukemias) were diagnosed over 37,659,582 person-years; 0.5% had in utero exposure to CT, 4.0% radiography, 0.5% fluoroscopy, 0.04% angiography, 0.2% nuclear medicine. The childhood-exposure cohort includes 3,724,632 children in whom 6,358 cancers (2,372 leukemias) were diagnosed over 36,190,027 person-years; 5.9% were exposed to CT, 61.1% radiography, 6.0% fluoroscopy, 0.4% angiography, 1.5% nuclear medicine.
The RIC Study is poised to be the largest study addressing risk of childhood and adolescent cancer associated with ionizing radiation from medical imaging, estimated with individualized patient organ dosimetry.
儿科和青少年癌症与医学影像（RIC）研究的风险正在量化胎儿和/或儿童医学影像累积辐射暴露与随后癌症风险之间的关联。本文描述了研究队列和研究方法。
RIC 研究是一项在美国六个医疗保健系统和加拿大安大略省的两个回顾性队列中对儿童进行的纵向研究，时间跨度为 1995 年至 2017 年。胎儿暴露队列包括其母亲在整个怀孕期间都在医疗保健系统中注册并随访至 20 岁的儿童。儿童暴露队列包括出生于该系统并在连续注册期间接受随访的儿童。使用行政数据确定成像利用情况。收集计算机断层扫描（CT）参数以估计个体患者的器官剂量。为放射摄影、透视和血管造影构建了平均暴露的器官剂量库，同时应用放射性诊断药物生物动力学模型来估计核医学程序中接受的器官剂量。通过当地和州/省癌症登记处的链接确定癌症。
胎儿暴露队列包括 3474000 名儿童，其中 37659582 人年中诊断出 6606 例癌症（2394 例白血病）；0.5%有宫内 CT 暴露，4.0%有放射摄影，0.5%有透视，0.04%有血管造影，0.2%有核医学。儿童暴露队列包括 3724632 名儿童，其中 36190027 人年中诊断出 6358 例癌症（2372 例白血病）；5.9%接受 CT 检查，61.1%接受放射摄影，6.0%接受透视，0.4%接受血管造影，1.5%接受核医学。
RIC 研究有望成为最大的研究，旨在解决与医学成像相关的儿童和青少年癌症的风险，该研究采用个体患者器官剂量估计。
