Estimated risks of radiation-induced fatal cancer from pediatric CT
Estimated risks of radiation-induced fatal cancer from pediatric CT
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DOI：
10.2214/ajr.176.2.1760289
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发表时间：
2001-02-01
影响因子：
5
通讯作者：
Berdon, WE
中科院分区：
文献类型：
--
作者：
Brenner, DJ;Elliston, CD;Berdon, WE
OBJECTIVE.鉴于儿童CT检查频率的迅速增加，我们研究的目的是评估儿童CT辐射导致的终生癌症死亡风险。材料和方法。器官剂量作为诊断时年龄的函数进行了估计，为普通CT检查，估计归因于终身癌症死亡风险（每单位剂量）的不同器官部位。采用了假定从中等剂量到低剂量的风险线性外推的标准模型。根据目前的标准做法，假设相同的暴露（毫安-秒），与年龄无关。与成人相比，儿童中较大的剂量和增加的终生辐射风险使CT的估计风险急剧增加。1岁儿童CT辐射暴露导致的终生癌症死亡风险估计为0.18%（腹部）和0.07%（头部）--比成人高一个数量级--尽管这些数字仍然代表癌症死亡率比自然背景率略有增加。在美国在15岁以下的儿童中，每年约有600.000例腹部和头部CT检查，粗略估计这些个体中有500例可能最终死于CT辐射引起的癌症。结论，最佳可用风险估计表明，儿科CT将导致比成人CT显著增加的终生辐射风险，这既是因为每毫安秒的剂量增加，也是因为每单位剂量的寿命风险增加。较低的毫安秒设置可用于儿童，而不会造成重大信息损失。尽管风险-受益平衡仍然强烈倾向于受益，因为儿科CT检查的频率正在迅速增加。据估计，接受CT的儿童的定量终身辐射风险不可忽略，这可能会刺激更积极地减少儿科患者的CT暴露设置。
OBJECTIVE. In light of the rapidly increasing frequency of pediatric CT examinations, the purpose of our study was to assess the lifetime cancer mortality risks attributable to radiation from pediatric CT.MATERIALS AND METHODS. Organ doses as a function of age-at-diagnosis were estimated for common CT examinations, and estimated attributable lifetime cancer mortality risks (per unit dose) for different organ sites were applied. Standard models that assume a linear extrapolation of risks from intermediate to low doses were applied. On the basis of current standard practice, the same exposures (milliampere-seconds) were assumed, independent of age.RESULTS. The larger doses and increased lifetime radiation risks in children produce a sharp increase, relative to adults, in estimated risk from CT. Estimated lifetime cancer mortality risks attributable to the radiation exposure from a CT in a I-year-old are 0.18% (abdominal) and 0.07% (head)-an order of magnitude higher than for adults-although those figures still represent a small increase in cancer mortality over the natrual background rate. In the United States. of approximately 600.000 abdominal and head CT examinations annually per Formed in children under the age of 15 years, a rough estimate is that 500 of these individuals might ultimately die from cancer attributable to the CT radiation.CONCLUSION, The best available risk estimates suggest that pediatric CT will result in significantly increased lifetime radiation risk over adult CT, both because of the increased dose per milliampere-second, and the increased lifetime risk per unit dose. Lower milliampere-second settings can be used for children without significant loss of information. Although the risk-benefit balance is still strongly tilted toward benefit, because the frequency of pediatric CT examinations is rapidly increasing. estimates that quantitative lifetime radiation risks for children undergoing CT are not negligible may stimulate more active reduction of CT exposure settings in pediatric patients.