Stewart Carly, Alber Susan, Mahendra Malini, Kofler Cameron, Tran Trung, Domal Sean, Bowles Erin J A, Weinmann Sheila, Greenlee Robert T, Stout Natasha K, Pequeno Priscila, Moy Lisa M, Duncan James R, Pole Jason D, Bolch Wesley E, Kwan Marilyn L, Miglioretti Diana L, Smith-Bindman Rebecca
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
Department of Public Health Sciences, University of California, Davis, CA.
J Pediatr Clin Pract. 2025 Jul 23;17:200166. doi: 10.1016/j.jpedcp.2025.200166. eCollection 2025 Sep.
To provide organ and effective radiation doses for common pediatric imaging examinations, which may help clinicians understand site-specific cancer risk, compare exposure across imaging modalities, and make informed care decisions.
Within a large multicenter retrospective cohort, imaging utilization and associated radiation doses were estimated for children enrolled from birth into one of six US health care systems. Doses are described for examinations performed from 2012 to 2017. For computed tomography (CT), doses were estimated using examination-level technical parameters, patient height and weight, and Monte Carlo simulations. For fluoroscopy, angiography, nuclear medicine, and radiography, dose maps were developed by patient age, sex, size, and year through Monte Carlo simulations using technical parameters collected from patient examinations. The mean dose and standard deviation (SD) were calculated for each examination type, and each modality's contribution to the cohort's cumulative effective dose was calculated.
Eight hundred thirty-five thousand six hundred forty-three imaging examinations in 278 909 patients are included. Radiographs were the most commonly performed exam but made up 6% of radiation dose exposure. CT exams made up 4% of imaging exams but accounted for 80% of exposure. Head CT was the most common CT exam (44% of all CT). For head CT, the average radiation dose to the bone marrow (associated with hematologic cancer risk) was 9.8 mGy (SD = 6.7) and to the brain (associated with brain cancer risk) was 39 mGy (SD = 14.8).
CT radiation doses to the bone marrow and brain fell within ranges associated with increased hematologic and brain cancer risk, and are highest in the youngest children.Keywords: Organ dose; effective dose; pediatric imaging; pediatric radiology; computed tomography; fluoroscopy; angiography; nuclear medicine; radiography; x-ray.
提供常见儿科影像检查的器官剂量和有效辐射剂量，这可能有助于临床医生了解特定部位的癌症风险，比较不同影像检查方式的辐射暴露情况，并做出明智的医疗决策。
在一个大型多中心回顾性队列研究中，对从出生起就纳入美国六个医疗保健系统之一的儿童的影像检查使用情况和相关辐射剂量进行了估算。描述了2012年至2017年期间进行的检查的剂量。对于计算机断层扫描（CT），使用检查级别的技术参数、患者身高和体重以及蒙特卡洛模拟来估算剂量。对于荧光透视、血管造影、核医学和X线摄影，通过使用从患者检查中收集的技术参数，通过蒙特卡洛模拟按患者年龄、性别、体型和年份绘制剂量图。计算每种检查类型的平均剂量和标准差（SD），并计算每种检查方式对队列累积有效剂量的贡献。
纳入了278909名患者的835643次影像检查。X线摄影是最常进行的检查，但仅占辐射剂量暴露的6%。CT检查占影像检查的4%但占辐射暴露的80%。头部CT是最常见的CT检查（占所有CT检查的44%）。对于头部CT，骨髓（与血液系统癌症风险相关）的平均辐射剂量为9.8毫戈瑞（SD = 6.7），大脑（与脑癌风险相关）的平均辐射剂量为39毫戈瑞（SD = 14.8）。
CT对骨髓和大脑的辐射剂量处于与血液系统和脑癌风险增加相关的范围内，且在最年幼的儿童中最高。关键词：器官剂量；有效剂量；儿科影像；儿科放射学；计算机断层扫描；荧光透视；血管造影；核医学；X线摄影；X射线
