Advertisement

Pediatric Radiology

, Volume 34, Issue 8, pp 624–629 | Cite as

Radiation dose and cancer risk to children undergoing skull radiography

  • Michael MazonakisEmail author
  • John Damilakis
  • Maria Raissaki
  • Nicholas Gourtsoyiannis
Original Article

Abstract

Background: Limited data exist in the literature concerning the patient-effective dose from paediatric skull radiography. No information has been provided regarding organ doses, patient dose during PA skull projection, risk of cancer induction and dose to comforters, i.e. individuals supporting children during exposure. Objective: To estimate patient-effective dose, organ doses, lifetime cancer mortality risk to children and radiation dose to comforters associated with skull radiography. Materials and methods: Data were collected from 136 paediatric examinations, including AP, PA and lateral skull radiographs. Entrance-surface dose (ESD) and dose to comforters were measured using thermoluminescent dosimeters. Patients were divided into the following age groups: 0.5–2, 3–7, 8–12 and 13–18 years. The patient-effective dose and corresponding organ doses were calculated using data from the NRPB and Monte Carlo techniques. The risk for fatal cancer induction was assessed using appropriate risk coefficients. Results: For AP, PA and lateral skull radiography, effective dose ranges were 8.8–25.4, 8.2–27.3 and 8.4–22.7 μSv respectively, depending upon the age of the child. For each skull projection, the organs receiving doses above 10 μGy are presented. The number of fatal cancers was found to be less than or equal to 2 per 1 million children undergoing a skull radiograph. The mean radiation dose absorbed by the hands of comforters was 13.4 μGy. Conclusions: The current study provides detailed tabular and graphical data on ESD, effective dose, organ doses and lifetime cancer mortality risk to children associated with AP, PA and lateral skull projections at all patient ages.

Keywords

Skull Radiography Radiation protection Radiation effect Children 

References

  1. 1.
    Berrington de Gonzalez A, Darby S (2004) Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 363:345–351CrossRefPubMedGoogle Scholar
  2. 2.
    International Commission on Radiological Protection (1991) 1990 Recommendations of theInternational Commission on Radiological Protection, ICRP publication 60. Pergamon Press, OxfordGoogle Scholar
  3. 3.
    National Council on Radiation Protection and Measurements (1989) Exposure of the U.S. population from diagnostic medical radiation, NCRP Report No.100. NCRP publications, BethesdaGoogle Scholar
  4. 4.
    Brenner DJ (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 32:228–231CrossRefPubMedGoogle Scholar
  5. 5.
    Roebuck DJ (1999) Risk and benefit in paediatric radiology. Pediatr Radiol 29:637–640CrossRefPubMedGoogle Scholar
  6. 6.
    Huda W (2002) Effective doses to adult and pediatric patients. Pediatr Radiol 32:272–279CrossRefPubMedGoogle Scholar
  7. 7.
    Hart D, Jones DG, Wall BF (1996) Coefficients for estimating effective doses from paediatric X-ray examinations, NRPB-R279. NRPB, ChiltonGoogle Scholar
  8. 8.
    Chapple CL, Faulkner K, Lee RE, et al (1992) Results of a survey of doses to paediatric patients undergoing common radiological examinations. Br J Radiol 65:225–231PubMedGoogle Scholar
  9. 9.
    Gallini RE, Belleti S, Berna V, et al (1992) Adult and child doses in standardised X-ray examinations. Radiat Prot Dosim 43:41–47Google Scholar
  10. 10.
    Kyriou JC, Fitzgerald M, Pettett A, et al (1996) A comparison of doses and techniques between specialist and non-specialist centres in the diagnostic X-ray imaging of children. Br J Radiol 69:437–450PubMedGoogle Scholar
  11. 11.
    Martin CJ, Farquhar B, Stockdale E, et al (1994) A study of the relationship between patient dose and size in paediatric radiology. Br J Radiol 67:864–871PubMedGoogle Scholar
  12. 12.
    Mooney R, Thomas PS (1998) Dose reduction in a paediatric X-ray department following optimization of radiographic technique. Br J Radiol 71:852–860PubMedGoogle Scholar
  13. 13.
    Ruiz MJ, Gonzalez L, Vano E, et al (1991) Measurement of radiation doses in the most frequent simple examinations in paediatric radiology and its dependence on patient age. Br J Radiol 64:929–933PubMedGoogle Scholar
  14. 14.
    Gogos KA, Yakoumakis EN, Tsalafoutas IA, et al (2003) Radiation dose considerations in common paediatric X-ray examinations. Pediatr Radiol 33:236–240PubMedGoogle Scholar
  15. 15.
    McDonald S, Martin CJ, Darragh CL, et al (1996) Dose-area product measurements in paediatric radiography. Br J Radiol 69:318–325PubMedGoogle Scholar
  16. 16.
    Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER (1998) Radiation protection in medical radiography, 3rd edn. Mosby, St LouisGoogle Scholar
  17. 17.
    Hansen J, Jurik AG, Ffigaard B, et al (2003) Optimisation of scoliosis examinations in children. Pediatr Radiol 33:752–765CrossRefPubMedGoogle Scholar
  18. 18.
    Hart D, Wall BF, Shrimpton PC, et al (2000) Reference doses and patient size in paediatric radiology, NRPB-R318. NRPB, ChiltonGoogle Scholar
  19. 19.
    Hart D, Jones DG, Wall BF (1996) Software: normalized organ doses for paediatric X-ray examinations calculated using Monte Carlo techniques, NRPB-SR279, NRPB, ChiltonGoogle Scholar
  20. 20.
    Robb JD (1994) Estimates of radiation detriment in a UK population, NRPB-R260. NRPB, ChiltonGoogle Scholar
  21. 21.
    Council Directive 97/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionising radiation in relation to medical exposure (1997) J Eur CommunGoogle Scholar
  22. 22.
    Hall EJ (2002) Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 32:700–706CrossRefPubMedGoogle Scholar
  23. 23.
    Hall P, Adami HO, Trichopoulos D, et al (2004) Effect of low doses of ionising radiation in infancy on cognitive function in adulthood: Swedish population based cohort study. BMJ 328:19–21CrossRefPubMedGoogle Scholar
  24. 24.
    European Commission (1996) European guidelines on quality criteria for diagnostic radiographic images in paediatrics, Report EUR 16261. Office for Official Publications of the European Communities, LuxembourgGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Michael Mazonakis
    • 1
    Email author
  • John Damilakis
    • 1
  • Maria Raissaki
    • 2
  • Nicholas Gourtsoyiannis
    • 2
  1. 1.Department of Medical Physics, Division of RadiologyUniversity Hospital of IraklionCreteGreece
  2. 2.Department of RadiologyUniversity Hospital of IraklionCreteGreece

Personalised recommendations