Cumulative Effective Doses From Radiologic Procedures for Pediatric Oncology Patients

OBJECTIVE: Our aim was to estimate the cumulative effective doses (CEDs) from radiologic procedures for a cohort of pediatric oncology patients. METHODS: 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. RESULTS: 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]). CONCLUSIONS: 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.