Radiation exposure from pediatric head CT: a bi-institutional study

Abstract

Medical radiation from CT should be kept as low as reasonably achievable (ALARA), particularly in young patients. To examine radiation dose from head CT in children in a trauma center (TC) and a regional children's hospital (RCH). A random sample of 240 children (0-3, 4-9, 10-14 years of age) from the TC were compared with a similar cohort from the RCH. All children had undergone at least one head CT scan without contrast enhancement; data from PACS and Department of Radiology Information System were used to estimate normalized effective dose (ED). Lifetime attributable risk of cancer incidence was estimated using the Biologic Effects of Ionizing Radiation (BEIR) VII report. The mean normalized ED was significantly higher in the youngest children at the TC (2.74 mSv in those aged 0-3 years vs. 2.23 mSv in those aged 10-14 years; P<0.001) and at the RCH (2.44 mSv in those aged 0-3 years vs. 1.71 mSv in those aged 10-14 years; P<0.001). Each decreasing year of age was independently associated with a 0.06 mSv higher mean normalized ED (P<0.001). After adjusting for the age difference between the institutions, the mean normalized ED was 0.44 mSv lower at the RCH than at the TC across all ages (95% CI 0.31-0.58, P<0.001). A higher lifetime attributable risk of cancer was associated with younger age. The radiation dose from head CT in children as defined by the normalized ED was highest in the youngest children and varied significantly between institutions in this bi-institutional study.