Radiation Risk from Medical Imaging in Children

  • Donald P. Frush
  • Kimberly E. Applegate

Key Points

■ Medical radiation currently accounts for an increasing percentage (approximately 50%) of the total radiation exposure for the US population (previously about 15%) (moderate evidence).

■ Children are 2–5 (some cite up to 10) times more sensitive to radiation than adults (moderate evidence).

■ There are no data that prove a direct link between low-level radiation from diagnostic imaging and cancer. The best data regarding long-term effects of low-level radiation (100–150 mSv) exposure come from the longitudinal survivor study (LSS) of atomic bomb survivors (moderate evidence).

■ Most major medical and scientific organizations accept the linear, no-threshold model as the preferred model for low-level radiation and cancer risk estimation.

■ The lifetime risk of fatal cancer from a single (relatively high dose) CT in a child has been estimated to be 1:1000 (limited to moderate evidence).


Cancer Risk Diagnostic Imaging Dose Length Product Radiation Risk Medical Radiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Huda W. Medical Radiation Dosimetry. Categorical Course in Physics: Radiation Dose and Image Quality. Chicago, IL: Radiological Society of North America, 2006; 167–182.Google Scholar
  2. 2.
    Frush DP, Slovis TL. In Slovis TL (eds.). Caffey’s Pediatric Diagnostic Imaging. Philadelphia: Elsevier, 2007, 29–41.Google Scholar
  3. 3.
    Imanishi Y et al. Eur Radiol 2005; 15:41–46.CrossRefPubMedGoogle Scholar
  4. 4.
    Hall HA et al. BMJ 2004; 328:1–5.CrossRefGoogle Scholar
  5. 5.
    Berrington A et al. Br J Radiol 2001; 74:507–519.PubMedGoogle Scholar
  6. 6.
    UNSCEAR 2000 Medical radiation exposures, annex D. United Nations Scientific Committee on the Effects of Atomic Radiation Report to the General Assembly; New York.Google Scholar
  7. 7.
    Gaca AM. Pediatr Radiol 2008; 38:285–291.CrossRefPubMedGoogle Scholar
  8. 8.
    Thierry-Chef I, Simon SL, Miller DL. Pediatr Radiol 2006; 36(14):159–162.CrossRefPubMedGoogle Scholar
  9. 9.
    Thomas KE, Wang BB. Age-specific effective doses for Pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients; a simple estimation method. Pediatr Radiol. In press.Google Scholar
  10. 10.
    Huda W, Vance A. Am J Roentgenol 2007; 188:540–546.CrossRefGoogle Scholar
  11. 11.
    Mettler FA, Thomadsen BR, Bhargavan M et al. Med Phys 2008; n95:502–712.Google Scholar
  12. 12.
    Fuchs VR, Sox HC. Health Affairs 2001; 20:30–42.CrossRefPubMedGoogle Scholar
  13. 13.
    Brenner DJ, Hall EJ. NEJM 2007; 357:2277–2284.CrossRefPubMedGoogle Scholar
  14. 14.
    Mettler FA, Wiest PW, Locken JA et al. J Radiol Prot 2000; 20:353–359.CrossRefPubMedGoogle Scholar
  15. 15.
    Amis ES Jr. et al. J Am Coll Radiol 2007; 4:272–284.CrossRefPubMedGoogle Scholar
  16. 16.
    Paterson A, Frush DP, Donnelly LF. AJR 2001;176(2):297–301.PubMedGoogle Scholar
  17. 17.
    Brenner DJ et al. Proc Natl Acad Sci USA 2003; 25: 100(24):13761–13766.CrossRefGoogle Scholar
  18. 18.
    BEIR VII. Health risks from exposure to low levels of ionizing radiation 2006. Last accessed 1-1-08.
  19. 19.
    Prasad KN, Cole WC, Hasse GM. Exp Biol Med 2004; 229:378–382.Google Scholar
  20. 20.
    Gonzalea AB, Darby S. Lancet 2004; 363:345–351.CrossRefGoogle Scholar
  21. 21.
    Ron E. Pediatr Radiol 2002; 32:232–237.CrossRefPubMedGoogle Scholar
  22. 22.
    Doody MM et al. Spine 2000; 25:2052–2063.CrossRefGoogle Scholar
  23. 23.
    Modan B et al. Int J Epidemiol 2000; 29:424–428.CrossRefPubMedGoogle Scholar
  24. 24.
    Spengler RF et al. Pediatrics 1983; 71:235–239.PubMedGoogle Scholar
  25. 25.
    McLaughlin JR et al. Int J Epidemiol 1993; 22:584–591.CrossRefPubMedGoogle Scholar
  26. 26.
    Kleinerman RA. Pediatr Radiol 2006; 36(2):121–125.CrossRefPubMedGoogle Scholar
  27. 27.
    Brenner DJ et al. AJR 2001; 176:289–296.PubMedGoogle Scholar
  28. 28.
    Donnelly LF et al. Am J Roentgenol 2001; 176:303–306.Google Scholar
  29. 29.
    Frush DP. In Kalra M, Saini S, Rubin G (eds.). MDCT: Form Protocols to Practice. New York: Springer, 2008; 333–354.Google Scholar
  30. 30.
    De Jong PA et al. Am J Respir Crit Care Med 2006; 173:199–203.CrossRefPubMedGoogle Scholar
  31. 31.
    Chodick G et al. Isr Med Assoc J 2007;9(8):584–587.PubMedGoogle Scholar
  32. 32.
    Frush DP, Applegate K. J Am Coll Radiol 2004; 1:113–119.CrossRefPubMedGoogle Scholar
  33. 33.
    Preston DL et al. Radiat Res 2007; 168:1–64.CrossRefPubMedGoogle Scholar
  34. 34.
    Preston DL et al. Radiat Res 2003; 160:381–407.CrossRefPubMedGoogle Scholar
  35. 35.
    Hall EJ. Pediatr Radiol 2002; 32:700–706.CrossRefPubMedGoogle Scholar
  36. 36.
    Prasad KN, Cole WC, Haase GM. Br J Radiol 2004; 77:97–99.CrossRefPubMedGoogle Scholar
  37. 37.
    Broder J, Fordham L, Warshaver D. Emerg Radiol 2007; 14:227–232.CrossRefPubMedGoogle Scholar
  38. 38.
    Medina LS, Kuntz KM, Pomperoy S. Pediatrics 2001; 108:255–263.CrossRefPubMedGoogle Scholar
  39. 39.
    Larson DB, Rader SB, Forman HP, Fenton LZ. Am J Roentgenol 2007 Aug;189(2):271–275.CrossRefGoogle Scholar
  40. 40.
    Brody AS, Frush DP, Huda W, Brent RL. Pediatrics 2007 Sep;120(3):677–682.CrossRefPubMedGoogle Scholar
  41. 41.
  42. 42.
    Larrier N, Lawrence T, Halperin EC. In Slovis T (ed.). Caffey’s Pediatric Diagnostic Imaging. Philadelphia: Elsevier, 2007; 13–25.Google Scholar
  43. 43.
  44. 44.
    Ron E et al. Radiat Res 1989; 120:516–531.CrossRefPubMedGoogle Scholar
  45. 45.
    Hall EJ. Radiobiology for the Radiologist, 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2000.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Donald P. Frush
    • 1
  • Kimberly E. Applegate
    • 2
  1. 1.Division of Pediatric Radiology, Department of RadiologyDuke Medical CenterDurhamUSA
  2. 2.Department of RadiologyEmory University School of MedicineAtlantaUSA

Personalised recommendations