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Computed tomography associated radiation exposure in children with craniosynostosis

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Abstract

Background

The role of computed tomography (CT) for diagnosis and surgical planning for craniosynostosis (CS) is well-established. The aim of this study was to quantify the cumulative medical radiation exposure from CT in patients with CS at a tertiary care children’s hospital.

Methods

Medical records of patients who presented at < 2 years of age and underwent surgical intervention for CS were examined for demographic information. Effective radiation dose (ERD) in mSv was calculated for each head CT. Descriptive statistics and ANOVA were performed. Mean ± SD is reported; p < 0.05 was considered significant.

Results

Two hundred seventy-two patients met inclusion criteria: 241 nonsyndromic and 31 with syndromic diagnoses. For nonsyndromic patients, mean age at first head CT was 6.0 ± 4.9 months, mean number of CT scans obtained was 2.1 ± 1.1, and the mean total combined ERD was 9.1 ± 4.8 mSv. CT scans obtained at < 6 months of age had a significantly greater ERD than those obtained at > 6 months, 5.3 ± 1.9 versus 4.3 ± 1.4 mSv, respectively (p = 0.001).

Conclusions

Patients with nonsyndromic CS undergo 2 CT scans on average related to their diagnosis, with a mean total ERD of 9.1 mSv; this is equivalent to 1.5 years of the average annual background radiation dose a person living in the USA will encounter from environmental radiation, medical exposures, and consumer products. A CT obtained at < 6 months is associated with a higher ERD; thus, we recommend delaying imaging from the initial presentation to the time of pre-operative planning when possible.

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Author information

Authors and Affiliations

  1. UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Madeleine K. Bruce, Lynda L. Flom, Miles J. Pfaff, Joseph E. Losee & Jesse A. Goldstein

  2. School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Aditya M. Mittal

  3. Office of Research Protections Radiation Safety, University of Pittsburgh, Pittsburgh, PA, USA

    Darunee S. Whitt

Authors
  1. Madeleine K. Bruce
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  2. Aditya M. Mittal
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  3. Darunee S. Whitt
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  4. Lynda L. Flom
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  5. Miles J. Pfaff
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  6. Joseph E. Losee
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  7. Jesse A. Goldstein
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Madeleine K. Bruce and Aditya M. Mittal. The first draft of the manuscript was written by Madeleine K. Bruce, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jesse A. Goldstein.

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Bruce, M.K., Mittal, A.M., Whitt, D.S. et al. Computed tomography associated radiation exposure in children with craniosynostosis. Childs Nerv Syst 37, 2635–2641 (2021). https://doi.org/10.1007/s00381-021-05254-0

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  • DOI: https://doi.org/10.1007/s00381-021-05254-0

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