title: Unnecessary irradiation to non-thoracic structures during pediatric chest radiography.
abstract: BACKGROUND
  Recent reports have indicated that infants and young children have a higher sensitivity than older children and adults to radiation exposure and the potential for harmful side effects.
  
  
  OBJECTIVE
  To determine whether the present landmarks used in film positioning result in unnecessary radiation to non-thoracic structures on chest radiographs in the pediatric and neonatal population.
  
  
  METHODS
  Chest radiographs of 195 pediatric patients and 149 neonates were analyzed for extent of radiation field to non-thoracic regions. This was accomplished by delineating the most superior and inferior portions of the body included within the boundaries of collimation on each chest radiograph. The distance between the superior and inferior aspects of the lungs was measured and compared to the long axis of the radiation field on the radiograph. Radiographic reports were reviewed to determine whether valuable data were obtained from the imaging of these non-thoracic structures.
  
  
  RESULTS
  The ratio of radiation exposure to non-thoracic structures increases as the age of the patient decreases. Overall, 43% of the length of the chest radiograph was of non-thoracic structures, resulting in radiation exposure to these sites. No significant information was gained in a single case by including the neck. In 3% of the neonatal patients, a potentially significant comment was reported on the abdomen included on the chest radiograph.
  
  
  CONCLUSIONS
  Present positioning techniques in neonatal and pediatric chest radiography result in unnecessary radiation exposure to non-thoracic structures. New landmarks for collimation should be sought to eliminate this problem.
authors.affiliation: Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada. daas@post.queensu.ca
authors.forename: Don
authors.initials: D
authors.lastname: Soboleski
authors.forename: Cynthia
authors.initials: C
authors.lastname: Theriault
authors.forename: Amy
authors.initials: A
authors.lastname: Acker
authors.forename: Vico
authors.initials: V
authors.lastname: Dagnone
authors.forename: David
authors.initials: D
authors.lastname: Manson
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011829:Radiation Dosage; D013902:Radiography, Thoracic / Q000009:adverse effects / Q000379:methods* / Q000592:standards*