Skip to main content
SpringerLink
Log in

Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

The onset of Crohn disease (CD) can occur in childhood. Imaging, which often involves radiation, is frequent in CD both for disease diagnosis and follow-up. However, information regarding radiation dose for contemporary CT and fluoroscopy is not available for determining the cost/benefit ratio for imaging strategies.

Objective

To compare effective dose (ED) for small-bowel follow-through (SBFT) and abdomen/pelvis MDCT in pediatric CD.

Materials and methods

Average fluoroscopic time and number of radiographs were obtained for 30 consecutive pediatric SBFTs. The numbers of SBFTs and CT scans performed per child among children with CD (1990–2005) were determined. The ED was determined (ICRP 60, 10-year-old phantom, MOSFET) for a 5-min fluoroscopy examination of the central abdomen and right lower quadrant (110 kVp, 0.3 mA) and pelvis (110 kVp, 0.35 mA). The ED for a 16-slice abdomen/pelvis MDCT scan was determined using the 10-year-old protocol: 16×1.25 mm, pitch 1.375, 27.5 mm/rotation, 0.5 s, 140 kVp, 85 mA.

Results

A total of 176 children with CD underwent imaging, averaging 1.2 SBFTs and 1.1 CT scans. On average SBFT took 5.1 min with 3.3 abdominal radiographs. The EDs (mSv) for a 5-min fluoroscopy were 0.15 for the central abdomen, 0.35 for the right lower quadrant, and 0.56 for the pelvis, yielding an average ED for SBFT (5-min fluoroscopy, 3.3 abdominal radiographs) of 1.8–2.2 mSv. The ED for MDCT was 3.48 mSv.

Conclusion

Although the ED for MDCT might be up to twice that for SBFT, excessive fluoroscopy time and number of abdominal radiographs can result in actual EDs that are equivalent. Attention must be paid to SBFT technique to minimize radiation dose and to the indication to determine the appropriate examination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rose JD, Roberts GM, Williams G et al (1988) Cardiff Crohn’s disease jubilee: the incidence over 50 years. Gut 29:346–351

    Article  PubMed  CAS  Google Scholar 

  2. Heyman MB, Kirschner BS, Gold BD et al (2005) Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr 146:35–40

    Article  PubMed  Google Scholar 

  3. Baldassano RN, Piccoli DA (1999) Inflammatory bowel disease in pediatric and adolescent patients. Gastroenterol Clin North Am 28:445–458

    Article  PubMed  CAS  Google Scholar 

  4. Sawczenko A, Sandhu BK (2003) Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child 88:995–1000

    Article  PubMed  CAS  Google Scholar 

  5. Jess T, Gamborg M, Matzen P et al (2005) Increased risk of intestinal cancer in Crohn’s disease: a meta-analysis of population-based cohort studies. Am J Gastroenterol 100:2724–2729

    Article  PubMed  Google Scholar 

  6. Kandiel A, Fraser AG, Korelitz BI et al (2005) Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut 54:1121–1125

    Article  PubMed  CAS  Google Scholar 

  7. Rosh JR, Gross T, Mamula P et al (2007) Hepatosplenic T-cell lymphoma in adolescents and young adults with Crohn’s disease: a cautionary tale? Inflamm Bowel Dis 13:1024–1030

    Article  PubMed  Google Scholar 

  8. Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296

    PubMed  CAS  Google Scholar 

  9. Vock P (2005) CT dose reduction in children. Eur Radiol 15:2330–2340

    Article  PubMed  Google Scholar 

  10. Hall EJ (2002) Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 32:700–706

    Article  PubMed  Google Scholar 

  11. Gubatova D, Varchenya V, Kristinya V (1989) Tissue equivalent phantoms in radiological protection. Kernenergie 32:10–13

    CAS  Google Scholar 

  12. CIRS (2007) Handling Instruction Manual, Atom Pediatric Ten Year Old Phantom. CIRS, Norfolk, VA

  13. Best Medical Canada (2007) Datasheets/publications. http://www.thomson-elec.com Accessed 4 October 2006

  14. Frush DP, Donnelly LF, Rosen NS (2003) Computed tomography and radiation risks: what pediatric health care providers should know. Pediatrics 112:951–957

    Article  PubMed  Google Scholar 

  15. Wall BF, Hart D (1997) Revised radiation doses for typical X-ray examinations. Report on a recent review of doses to patients from medical X-ray examinations in the UK by NRPB. National Radiological Protection Board. Br J Radiol 70:437–439

    PubMed  CAS  Google Scholar 

  16. Gorson RO, Lassen M, Rosenstein M (1984) Patient dosimetry in diagnostic radiology. Handbook of medical physics, vol II. CRC Press, Boca Raton, pp 467–526

    Google Scholar 

  17. NCRP (1989) Exposure of the U.S. Population from Diagnostic Medical Radiation: Report no. 100. NCRP, Bethesda, MD

  18. Mettler FA Jr, Wiest PW, Locken JA et al (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359

    Article  PubMed  Google Scholar 

  19. Donnelly LF (2005) Reducing radiation dose associated with pediatric CT by decreasing unnecessary examinations. AJR 184:655–657

    PubMed  Google Scholar 

  20. Jabra AA, Fishman EK, Taylor GA (1991) Crohn disease in the pediatric patient: CT evaluation. Radiology 179:495–498

    PubMed  CAS  Google Scholar 

  21. Jabra AA, Fishman EK, Taylor GA (1994) CT findings in inflammatory bowel disease in children. AJR 162:975–979

    PubMed  CAS  Google Scholar 

  22. Jamieson DH, Shipman PJ, Israel DM et al (2003) Comparison of multidetector CT and barium studies of the small bowel: inflammatory bowel disease in children. AJR 180:1211–1216

    PubMed  Google Scholar 

  23. Morgan HT (2002) Dose reduction for CT pediatric imaging. Pediatr Radiol 32:724–728; discussion 751–754

    Article  PubMed  Google Scholar 

  24. Huda W, Vance A (2007) Patient radiation doses from adult and pediatric CT. AJR 188:540–546

    Article  PubMed  Google Scholar 

  25. Darbari A, Sena L, Argani P et al (2004) Gadolinium-enhanced magnetic resonance imaging: a useful radiological tool in diagnosing pediatric IBD. Inflamm Bowel Dis 10:67–72

    Article  PubMed  Google Scholar 

  26. Durno CA, Sherman P, Williams T et al (2000) Magnetic resonance imaging to distinguish the type and severity of pediatric inflammatory bowel diseases. J Pediatr Gastroenterol Nutr 30:170–174

    Article  PubMed  CAS  Google Scholar 

  27. Ott DJ, Chen YM, Gelfand DW et al (1985) Detailed per-oral small bowel examination vs. enteroclysis. Part I: Expenditures and radiation exposure. Radiology 155:29–31

    PubMed  CAS  Google Scholar 

  28. Thoeni RF, Gould RG (1991) Enteroclysis and small bowel series: comparison of radiation dose and examination time. Radiology 178:659–662

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Duke University Medical Center, P.O. Box 3808, Durham, NC, 27710, USA

    Ana Maria Gaca, Tracy A. Jaffe, Terry Yoshizumi, Greta Toncheva, Giao Nguyen & Donald P. Frush

  2. Department of Radiology, Dartmouth General Hospital, Dartmouth, NS, Canada

    Susan Delaney

Authors
  1. Ana Maria Gaca
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tracy A. Jaffe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Susan Delaney
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Terry Yoshizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Greta Toncheva
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giao Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Donald P. Frush
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Maria Gaca.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gaca, A.M., Jaffe, T.A., Delaney, S. et al. Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38, 285–291 (2008). https://doi.org/10.1007/s00247-007-0702-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-007-0702-z

Keywords

Search

Navigation